Picture of John Choi, MD MEd

John Choi, MD MEd

Resident Consultant – Stanford

Impact

*For privacy purposes names have been altered.

This month’s resident column was originally meant to be an expository piece on the role of mentorship throughout neurosurgical training, but I spontaneously found myself writing an entirely new reflection when I read this excerpt from an email I received about two hours ago:

Dr. Choi,

I wanted to let you know that I decided that I would pursue medicine after all and even though I am still not sure if I will be able to do neurosurgery, I hope we can be colleagues one day and operate on the brain together.

To provide context, this email came from a first-year undergraduate student who was enrolled in a course I taught earlier this fall at Stanford. The class, titled “Neurosurgical Frameworks”, aimed to expose undergraduate students to the fascinating world of neuroscience through a clinical lens via patient interviews and case studies. As part of that class I had weekly office hours, and it was at the end of the term that I met Julia*.

A Human Biology major, Julia was the first of her family to attend college and had grown up in a small rural town with a population size that was less than the number of undergraduate students at Stanford. Despite being academically brilliant, she had little exposure to medicine and found her first year at Stanford to be stifling—her fellow first-year classmates casually mentioned how they were co-authors on a Nature paper, how they had already done over 200 hours of shadowing in high school, and how they were giving TEDx talks on leadership and motivational speaking. Julia had never read a Nature paper, the only doctors she knew were the ones she had to receive vaccination records from, and she was at Stanford on a scholarship and had to work to be able to provide for her daily living expenses. Despite her relative inexperience with doctors, she had always dreamed about being one after watching an episode of House, but she found herself hitting a seemingly insurmountable barrier already at the start of her academic career.

As I listened to Julia share her story, I couldn’t help but draw parallels to another student: myself. I had never shared this—not even with my closest mentors in college or medical school—but I grew up under a single mother who had to work multiple jobs to support my sister and me. I vividly remember folding white and pink sparkling ribbons on metal clips at the age of 5 and walking around with my mom to help sell them in affluent neighborhoods. I distinctly remember the happiness I felt from when we qualified for food stamps and I got to finally try the chicken Caesar salad in middle school, and then the subsequent shame when my friends asked me why I had to use food stamps. I was eventually fortunate enough to go to college through a generous scholarship, but even then I remember pretending to be full whenever I went out with friends because I could not afford to split the check.

So for the first time ever, I shared my story with Julia. I told her how I had almost no experience with medicine prior to coming to college. How it was through the kindness of incredible mentors that believed in me more than I believed in myself that I eventually found myself in medical school and now residency. That when I feel like I am at my limit physically and mentally, I am still so thankful that I even have this opportunity to work with patients in such an incredible capacity.

And Julia cried that day in office hours. I could tell that there was still a lot of doubt, but her profound relief that she was not alone—that there were others who had also secretly doubted themselves and wondered if they deserved to be where they were—provided a small measure of catharsis. And truly, she was not alone. As part of the course, I included weekly anonymous surveys at the start of class to track attendance numbers as well as several demographic questions.

In a class of over a hundred students, 7% of students initially stated that they were interested in pursuing a career in neurosurgery. That number became over 85% by the end of the course. 34% of the class identified as an underrepresented minority and about 60% of students identified as female. On the last survey of the class, of those students who identified as either female and/or an underrepresented minority, over 90% said they would seriously consider neurosurgery as a career option. In their end of term reflection, dozens of students shared similar sentiments to Julia in how they had previously felt overwhelmed and displaced in their pursuit of becoming a doctor, but were reinvigorated into pursuing a career in medicine.

As neurosurgeons, we have so many opportunities for positive impact. I feel privileged that I can help my patients through my clinical training. I am also extremely fortunate to have funding and departmental support to perform rigorous scientific work during my research years. But I cannot discount that one of the greatest ways I can help others at this time comes from my role as an educator and mentor. Just as my own mentors inspired me to enter this field, I look forward to welcoming Julia as a colleague one day—and what a day that will be.