Describe the community in which you were nurtured or spent the majority of your early development with respect to its demographics. What core values did you receive and how will these translate into the contributions that you hope to make to your community as a medical student and to your career in medicine? What improvements do you think might make the described community better?

Growing up in a suburban community in San Mateo, California, my life was very sheltered. Our community was composed of largely middle to upper class residents, with a large proportion of people with Caucasian and Asian ethnicities. Many of my friends and their families were well-off with little to no financial burden, and as a result, my core values in life were simple: work hard in school and be kind to others, and one would have a good, successful life.

When I went to college at the University of California, Berkeley, the community I experienced there was shockingly different from the one I had grown up in. Although there was still a large proportion of Asian students, there were many students of other ethnicities, having traveled from countless countries to attend the university. As these students became my friends, study partners, mentors, and students, I realized that the core values I held were naïve and oversimplified how one should interact with others on a daily basis. Life was not just about being kind to others, tolerating one another’s existence, but actively engaging with others in conversation and shared moments and being exposed to their perspectives, beliefs, preferences, and dreams. Through these experiences, I learned how to appreciate where the other person is coming from and be both mindful and respectful of our differences; my worldview broadened with each person I met. My community at UC Berkeley therefore taught me the values of humility and cultural competence, values I hope to translate into showing compassion and empathy to my community as a medical student and providing health care to patients that is mindful of their cultural backgrounds and socioeconomic statuses. These values will also help me become a physician whose care is patient-centered.

Attending college at UC Berkeley also taught me the importance of tenacity. Learning in classes as large as 1500 students, it was often difficult to keep up with understanding the curriculum and studying in an environment where many other students were also stressed and discouraged. To combat these challenges, my classmates and I formed study groups to support one another in the learning process. Even in the face of many failed quizzes and tests, we refused to lose hope or give up. Given the challenging medical school curriculum, I hope to also bring my peers together to support one another in learning and applying the medical school material. I also know that there will be many challenges in being able to secure resources and health care that my future patients will need, and it will be up to me to resiliently push against these challenges as my patients’ advocate.

As I return to San Mateo after finishing my undergraduate degree at UC Berkeley, the quiet, sheltered atmosphere is both familiar and incomplete. I believe that if my hometown had the same level of ethnic and cultural diversity that I experienced at UC Berkeley, we would be given the privilege of interacting with more people of different backgrounds and have our worldviews broadened each day. I believe that the people in my community would also be humbler, aware that their neighbors may not be as financially secure as they are. In the end, however, I am grateful for the immeasurable impact that the UC Berkeley community has had on my values and in shaping me as a future physician.

Describe a situation where you have chosen to advocate for someone who is different from yourself. What does advocacy mean to you and how has your advocacy developed? How do you see it linked to your role as a physician/leader? What risks, if any, might be associated with your choice to be an advocate?

Sitting across from an elderly woman whom I was meeting for an individualized health coaching appointment, I couldn’t help but notice how similar we were. We were both Chinese, loved eating Chinese food, had one sister, and had a tendency to giggle when we laughed. However, there were many differences between us too: an age gap between us of over 60 years, different cultural backgrounds, and different medical histories, to name a few. And there was one difference that had a crucial impact on our appointment; while Chinese was her first language, my Chinese was limited at best, and the language barrier often interfered with how much information she could understand from our appointments together.

I asked if she had understood what I had just explained from the handout we were going over, and when she shook her head in response, I knew that things had to change. As her health coach and advocate, it was my responsibility to not only understand her health priorities and goals, but also ensure that those goals were achieved. And if the language barrier between us was preventing her from communicating her health goals and obtaining the health information and resources that she needed, I would do all that I could to break the barrier down.

I used to think that advocacy meant obtaining resources that would most benefit the person based on immediate problems that they seemed to be facing. In the hospital, this might look like a doctor prescribing pain medication to ameliorate a back problem his patient is suffering. However, I came to understand that my definition of advocacy was missing a crucial component: understanding and acting on the patient’s wishes, not what you believed to be the best for the patient. So the patient experiencing back pain may not want to relieve it through medications, but through methods like exercise and following more ergonomic practices at work, and advocating for that patient would mean obtaining ergonomics information and recommending appropriate exercises.

As the elderly woman used limited English to describe the health topics she wanted to learn about during our appointments, I asked clarifying questions to ensure that I had understood her accurately and completely. In my handouts, I annotated complex medical terms such as “peripheral neuropathy” with their Chinese translations so that she could understand more of the information, and printed out health information in Chinese whenever possible. That way, she would be able to get the most out of handouts tailored to her interests.

However, my quest to break down the barriers impeding my elder partner’s wishes was not always easy. During health coaching meetings, I pushed for the recruitment of more health coaches who could speak multiple languages, as well as the translation of our existing pamphlets of health information into other languages. This would not only increase the accessibility of our program, I explained, but also allow more elders to have their voices heard and needs met. My ideas were met with hesitation due to the fact that our resources and time were already limited and most of the other health coaches worked with English-speaking elders, but I was motivated to continue pursuing these goals despite the lack of support.

To be an advocate is to be the voice of someone who is otherwise unable to achieve the resources they need, and requires empathy, understanding, and tenacity. As a future physician, I hope to understand my patients’ health wishes completely so that I am able to provide the resources they need to confidently achieve their health goals.

What has been your most humbling experience and how will that experience affect your interactions with your peers and patients?

“What do you know about alcoholism and diabetes?”

This was our third individualized health coaching meeting with an elder who, having grown up in a German household, was used to drinking heavy amounts of alcohol in his childhood and teenage years. The habit had followed him to adulthood, and while it was clear that his alcoholism was having a negative effect on his diabetes, he was reluctant to give up drinking at least one bottle of wine a day despite suggestions from my health coaching partner and me. “I look forward to it each night,” he replied when we asked. “It helps me unwind at the end of a busy day.”

My health coaching partner and I agreed that making and presenting a handout to the elder explaining the negative effects of alcoholism on diabetes might help change his mind. As I was in charge of preparing the handout that week, I made sure to include information that was thorough but concise, hoping that the connections would convince the elder to start reducing his daily alcohol intake.

While the elder said that he knew that the two conditions were related, he did not know to what extent. I used this opportunity to explain what I had prepared in my handout. “When one consumes alcohol, the liver works to detoxify it and cannot regulate blood sugar,” I explained, pointing to the relevant line of text. “Therefore, alcoholism can cause blood sugar levels to drop to dangerous levels.”

As I continued to explain the rest of the handout, I didn’t notice the elder’s interest fade as he withdrew deeper and deeper into his own thoughts. He had stopped paying attention after I said “dangerous levels,” and I was about to explain the next section of my handout when my health coaching partner interjected to address the elder directly.

“It looks like you’re taking the information pretty seriously. How are you feeling about it?”

My health coaching partner’s question startled me, and for the first time during our meeting, I looked up at the elder to see a look of numb shock on his face. I couldn’t believe that I hadn’t noticed his reaction to the information until that moment, and the fact that I had been so focused on presenting the information that I neglected considering how he would respond made me feel ashamed. Putting aside the handout, I watched as the elder took a shaky breath and told us that he finally understood how serious his alcoholism was, and that he was ready to start limiting how much wine he drank each night. The rest of our meeting was a conversation as we worked together to prepare a game plan of how much he would reduce his alcohol consumption each night, and I was struck by how much it starkly contrasted to the one-sided lecture I had given during the first half of our appointment.

The experience I had with my elder and health coaching partner not only impacted the rest of my individualized health coaching appointments, but also humbled and taught me to be more considerate and mindful of those around me. During each subsequent appointment, I put my elder patients first, prioritizing their needs and responses to the material I presented over the presentation itself. During our health coaching meetings, I started asking my fellow health coaches for their opinions and feedback rather than authoritatively stating my own. And for my future patients, I am grateful that this experience humbled me to put their needs first so that I can truly provide health care tailored to their wishes.

What qualities will you bring to the practice of medicine?

When a patient goes to the hospital, who do they expect to see?

Do they expect to see someone who can tell them the reason for their unexplainable headache and suggest a treatment that does not involve medications? As a future physician, it will be my responsibility to not only diagnose the causes of health conditions, but also provide solutions tailored to the patient’s lifestyle. Learning the causes behind a myriad of health conditions and their treatments requires intellectual vitality and tenacity, and I aim to bring both qualities to my first few years of medical school as I learn the curriculum with my classmates. I look forward to also using my leadership skills to bring my classmates together in study groups to ensure that all of us keep up with learning the material and are able to apply what we learn to practice.

Do they expect to see someone who will listen as they describe their health conditions and not be distracted by the thought of other appointments later in the day? As a physician, I aim to provide patient-centered care, giving my undivided attention to the patient during their appointment so that I can understand their health concerns completely and accurately. I want to respect the patient taking time out of their busy schedule to come see me and ensure that their concerns are addressed seriously during our time together.

Do they expect to see someone who will support them as they cope with a terminal condition and provide them care options without bias? During these vulnerable moments, patients can often feel lost and hopeless, and I want to be a source of emotional support for them. Knowing that some patients will prefer hospice care for their terminal conditions over treatments, such as chemotherapy for cancer, I also want to give them flexibility in their treatment options so that their health preferences can be met.

Do they expect to see someone who will eventually give them a warm handoff to a nurse who will provide needed vaccines or a pharmacist who knows which prescriptions they will need to get filled? Teamwork and cooperation is crucial to the health care field, and I look forward to working with my staff in order to provide the best possible care for our patients. I will do my best to ensure that all of us are well-supported in our roles and ask my staff for their feedback often so that all of us will play an important part in the decisions we will need to make daily regarding our patients.

Patients come to the hospital for a variety of reasons, but they will always expect to see someone who can guide them through understanding their health conditions and care options. Through bringing qualities such as tenacity, compassion, respect, flexibility, teamwork, and humility to the practice of medicine, I hope to ensure that patients leave the hospital satisfied, having met with the person they had expected to see, as well as confident that their next visit will be just as successful.

Describe a situation where you failed. What did you learn from the experience? Describe at least one functional impact of the experience.

I checked my watch as I arrived to a classroom that was almost empty, save for one student sitting at a computer. It was half an hour earlier than class was scheduled to start, a perfect opportunity to speak with one of my students about his performance in the computer science course I was helping teach.

The student had emailed asking to talk about how he could improve in the course after receiving poor grades on a recent midterm, and to prepare for the meeting, I had brainstormed study strategies with other teaching assistants who had encountered similar situations with their students. I felt certain that the list of strategies was thorough, but I was still nervous about being able to address the student’s concerns.

After the student explained his discouragement about the grades he had received, I asked him to describe his study strategies, hoping that the ones I had brainstormed could help him out. To my dismay, the strategies he described were almost exactly identical to the ones I had prepared. “Did you try…” was the expression I repeated over and over, each time with a new strategy that I hoped could try to turn his grades around, but each time he would respond that he had already attempted the technique to no avail. He grew more discouraged with each failed suggestion and eventually waved me off, saying that he would “figure something out” with frustration tinging his voice. I tried to reassure him that he could ask me for help anytime he was confused about a question, but by then he had withdrawn into his thoughts and was staring listlessly at code on the computer screen.

As his instructor, I thought I had completely failed my student by running out of advice to give him during his time of need, and expected him to look for guidance elsewhere. So it surprised me when I found an email from him the next day asking for help on a homework question he was stuck on. Even if I hadn’t been able to help him before, I realized that the next best thing I could give him was my time and persistence. I responded with the best explanation that I could type out, and thus began a transformation that I hadn’t expected to see. Not only did he strive to understand tricky concepts and problems over our email conversations, but as his understanding of the topics grew, so did his confidence. I saw him raise his hand to participate in discussion sessions more, less fearful of giving a wrong answer.

I realized then that not all problems have an immediate or convenient solution, but what can really impact someone is promising to be there for them and support them every step of the way. I applied this realization to supporting my other students in their endeavors, as well as encouraging my elder partners as a health coach for the Berkeley Health Coaching program. When the elders came to me with medical conditions that did not have an immediate cure, I still vowed to support them emotionally and intellectually by providing handouts of relevant health information; I was amazed to see their ability to manage their medical conditions improve with each appointment. I know that I will take this experience with me as I support my future patients as a physician.

What role has research had in your preparation for medicine?

Working on my own research project in the Lindow lab at UC Berkeley has taught me the importance of collaborating with others to think outside of the box. My project aimed to discover genes in a plant pathogenic bacterium involved in surface detection, and to troubleshoot experimental procedures, I worked closely with my graduate student supervisor and PI. As my project progressed, I encountered new questions and problems to answer and solve, leading me to collaborate with other lab members to receive advice on which lab techniques would be best suited for the problem. A few techniques were successful with the first attempt, but many other steps in the experiment required fine-tuning and constant revision with each new experiment, and I learned how to adjust my protocols to fix these issues. Similarly, the field of medicine also has challenges and problems to tackle that require both innovation and collaboration. Working together to improve the health of our patients, I look forward to partnering with other physicians and medical staff in order to research new ways to cure existing diseases as well as prevent them from occurring. The tenacity that I developed while troubleshooting experimental procedures will also help me continue to support patients with complex or terminal medical conditions, as treatments I prescribe to them will not always be successful. I also hope to use the techniques I learned in the microbiology lab to research and combat the spread of pathogenic bacteria and antibiotic resistance.