Following the 2016 election, nearly 200 Feinberg students and faculty laid down their white coats in a symbolic gesture, protesting the proposed repeal of the Affordable Care Act (ACA). Jordan Rook, a co-organizer of the event and now a fourth-year student, was struck by his classmates’ willingness to protest policy they perceived as harmful.
In the weeks that followed the protest, he asked himself: “How do we show that medical students believe advocating for health policy is our responsibility?”
With the help of students and faculty at Feinberg and beyond, Rook conducted a large survey on medical students’ policy beliefs, receiving responses from more than 1,600 students across the country. The results of his study were published in the journal Academic Medicine, and Rook believes the trends revealed could inform both medical educators and policymakers alike.
Read a Q&A with Rook below.
Why did you choose Feinberg?
I chose Feinberg because I wanted to live in a city with diversity, history and culture. The past four years have confirmed that I made the right decision. I am beyond lucky to have had the opportunity to explore the restaurants, museums and neighborhoods that Chicago has to offer. Additionally, the quality of students and faculty at Northwestern has pushed me to be a better student, physician and servant leader.
Why were you interested in measuring students’ political engagement?
Healthcare is a human right. Throughout much of the developed world, this is a fact. Unfortunately, in the United States, access to healthcare — especially high-quality healthcare — is a privilege of which many are deprived. I believe that no person should suffer or die because of where they were born, what they have, or who they are. Even as medical students, we see early and often how the uninsured and underinsured suffer in our current medical system. They often present in advanced disease states and with illnesses we can no longer manage or cure.
In the weeks that followed our protest, I couldn’t help but ask, “How do we continue to show the world that we are not outliers, and that medical students support the ACA?”
Our project was born from this question. With the help of fellow Northwestern medical students Jacob Pierce and Antoinette Oot, a team of students and faculty at six other medical schools, and the guidance and mentorship of Dr. Bruce Henschen and Dr. Tyler Winkelman at Hennepin County Medical Center in Minneapolis, MN, we conducted the largest study of medical student opinions regarding the ACA and professional responsibility since the 2016 election. In total, 1,660 medical students from seven medical schools across the country responded to our survey.
What did you find?
We had three major takeaways from this study.
First, students support the ACA and its individual components. Overall, nine in ten students stated they support the ACA, eight in ten support the individual mandate, and only one in ten believe the ACA will negatively affect their career in medicine. This level of support is significantly higher than previous generations of medical students and may reflect a growing familiarity and understanding of the health law. Students who demonstrated better knowledge of the ACA were more likely to support the health law, irrespective of political belief.
Second, medical students want an active and vocal role in the formation of health policy. In total, nearly nine in ten students indicated that addressing health policy is a professional responsibility.
Third, physician demographics are changing. Overall, 78 percent of students identified as liberal. This is 20 percentage points higher than in 2014 and nearly 40 percentage points higher than in 2003. We believe this is due to an evolving physician workforce. Demographics associated with conservative political ideology in physicians, namely male sex and private practice, are shrinking in modern medicine. Women now represent more than half of matriculants to medical school compared to one-third in 1980.
We believe this study has important implications for educators. Our findings suggest that academic institutions should expand evidence-based decision-making curricula to the evaluation of healthcare policy. Knowledge impacts support, and it is imperative students are provided with the tools to identify policies that improve care and reduce the burden of healthcare costs. Additionally, institutions should provide formal advocacy training to teach students the tools to advocate for health policy, especially given that nine in ten students believe this to be a component of their practice of medicine.
For legislators, our takeaway points are more concise. First, young physicians will likely support policies that expand access to healthcare. Second, they’ll be hearing from us!
What did you learn in the process of designing, carrying out and publishing this study?
I learned how much fun research can be if you work with passionate and inspiring people. This project was one big team effort, from project design to manuscript writing. I cannot give enough credit to our collaborators at each of the medical schools, my classmates here at Northwestern and my mentors. While the goal of research is to improve the world in which we live, it is a pleasant side effect that it improves us as investigators and physicians. My collaborators make me a better person, and I’m lucky to have them as lifelong friends!
What advice would you give to prospective medical students?
We do this for our patients! Make sure to always remember the reason you’re studying late at night or waking up in the wee hours of the morning. We’re beyond lucky to get to share with our patients the scariest (and sometimes most joyous) moments of their lives.
