AMSA International Chapters
Megan Maraynes discusses how the American Medical Students Association (AMSA) inspires medical students to take a global perspective
AMSA’s mission consists of a commitment to advancing the field of medicine and delivering health care to all people. It emphasizes students’ exposure to the ethical and moral obligations of medicine and strives to tackle world health problems. AMSA is self-governed by students and provides countless leadership opportunities for members to take an active role in shaping current and future policy. Because of AMSA’s dedication to global healthcare issues, it is not surprising that it is not just for students from American Medical schools. There are over 40 medical school chapters outside of the USA with over 4,000 international members.
International medical school chapters have the freedom to design their own activities and projects throughout the year, and are eligible for AMSA’s financial support in funding these initiatives through a local project grant program. AMSA provides students with an outlet to engage in activism and discuss health issues with other students from around the world who share their passion and vision. My personal involvement in AMSA has had a strong influence on my understanding of global healthcare issues and the kind of doctor I want to be.
Since my acceptance into St. George’s University, I have looked forward to the third year of medical school as one of the biggest milestones in my medical career. Whenever the cycle of lectures followed by exams seemed fruitless, I would find solace in anticipation of “the third year”, when my life would revolve not around books and notes but real medicine and real people. As I approach the end of the year, I realize how much my view of medicine has changed. I now know the reality to be this; there will always be moments of frustration when you ask yourself “why am I doing this?” whether you are a first year, third year, resident or attending.
In any profession, there is a romanticized version, and there is reality. My fantasy of medicine painted it as a profession in which doctors listen patiently and emphatically, examine gently and respectfully, explain calmly and precisely, and always do the best they can for the patient. In reality many doctors don’t listen because they don’t have time to hear extraneous information. Many don’t have the patience or time to translate medical information into laymen’s terms. Oftentimes, patients are discharged without having received the most comprehensive care and education available simply because residents are too overworked. Medical students fall into the trap as well. We are competing for residencies, and too often become so pre-occupied with impressing attending physicians for letters of recommendation that we forget about working together for the sake of learning collaboratively and for the good of the patients. Hospitals themselves add to the nonsense. Policies and procedures too often override what would be most practical and efficient in caring for patients.
When I was studying in the Caribbean, my days were filled with books, lectures and multiple choice questions. Patients were faceless figures deep in my imagination mentioned only for the purpose of illustrating pathophysiological concepts. In an effort to complement the overwhelmingly academic part of my life, I became involved in my school’s AMSA chapter, eventually taking on a leadership position as vice president. We led activism campaigns for issues like ‘pharm-free’ and national AIDS awareness day, as well as held fund-raisers for community causes. By far the most meaningful AMSA experiences were the community health fairs. Three times each semester we went into the underserved community with our stethoscopes, tuning forks, opthalmoscopes and eye charts. Once there, we performed physical exams and provided referrals, prescriptions, and education with the help of some volunteer physicians. We weren’t saving lives; we were simply hoping to improve them in some capacity. Perhaps it was charity; perhaps we weren’t ultimately changing the structure of the system that prevented such healthcare from being more accessible. We certainly weren’t ending poverty. But our intentions were genuine, and the experience was powerful.
When I feel frustrated with bureaucracy in my New York hospital, or the inherent disjointedness of my education, I often think back to our AMSA community health fairs in Grenada. They were so uncomplicated. We went into the community, talked to people about their lives, and used our undeveloped clinical skills and scarce resources to provide them with whatever healthcare we could. We were trying as best we could to utilize what knowledge we had gained to make a contribution to society. I must always remind myself that this is why I want to be a doctor.
I am disenchanted but not disillusioned. Doctors are not perfect. Hospitals are far from perfect. But there do exist moments when it seems as if something is getting done, patients are improving, change is happening. It is a vague and basic sense of fulfillment, yet it pulses through the hospital with a firm and regular beat.
That simple fact kept me going then, and now, as I look forward to the next milestone; the time when I can use my education to work towards lessening the inequalities in health care around the world.
Megan Maraynes
3rd year medical student
St. George’s University
Grenada, West Indies
meganmaraynes@gmail.com