An Open Letter to Our Former Dean, Dr Stanley Goldfarb, From 150+ Alumni of the University of Pennsylvania School of Medicine

Crystal Zheng, MD, MA

September 20, 2019

Dear Dr Goldfarb,

As graduates of the University of Pennsylvania School of Medicine, we strongly disagree with your opinion piece in the Wall Street Journal, "Take Two Aspirin and Call Me by My Pronouns," in which you argue that medical school curricula should not include topics related to "social justice" at the expense of "basic scientific knowledge."

While we acknowledge and respect your contributions to medical education, we feel compelled to express publicly our objection to your editorial, in which you name policy, population health, eliminating health disparities, cultural diversity, bias, climate change, gun violence, transgender health (unnamed, but alluded to in the title) and other "progressive causes" as unworthy of having a place in medical education. Our goal here is not to engage in a point-counterpoint debate. In the Philadelphia Inquirer, Penn faculty members have already provided several examples of the interaction between medicine and the social justice issues in question.

We could spend the remainder of this letter listing the innumerable additional examples from our daily experiences. We could point out the flaws in your arguments that science alone can achieve cure, that teaching social justice would dilute a "demanding" and "rigorous" curriculum, and that producing more "oncologists, cardiologists, surgeons and other medical specialists" is a more worthy objective than producing primary care doctors.

Instead, we want to convey our disappointment in your limited view of the scope of medicine and let you know how your words have impacted us personally. As the associate dean of curriculum, you likely reviewed our medical school applications. Go back and read them. You will find that many of us wrote about a desire to help people, particularly the disenfranchised, to advocate for our patients, and to blend the scientific and humanistic sides of ourselves to become socially conscious physicians. Yet in one fell swoop you have rejected the worth of our core personal and professional identities. Some of us sat on curriculum committees with you. All of us were affected by your decisions. We trusted you to curate what we learned, or in this case did not learn. We trusted you to equip us with skills that would enable us to practice medicine in a country with a critical physician shortage in both primary care and specialties, mounting healthcare expenditures, and an increasingly diverse population in terms of race, sexual orientation, and socioeconomic status. We trusted you with our medical education, our professions, ourselves.

You will contend that social justice issues are not irrelevant to, but simply belong elsewhere in a physician’s education. But to teach these issues in isolation of medicine defeats the point. An undergraduate psychology course covering bias would not necessarily prepare medical students to recognize it when making clinical decisions, nor would a gun violence seminar teach them how to ask about access to firearms during a patient interview. Separating social justice from medicine deprives students of the opportunity to apply concepts into clinical practice and sends the message that these issues are independent rather than intertwined.

In response to an email from Penn Medicine leadership affirming the school’s commitment to a well-rounded education, the Wall Street Journal Editorial Board suggested, "Maybe we should begin to wonder about the quality of the doctors who graduate from Penn." We both know the answer to that question. Penn Medicine is a name recognized throughout the country as one of the premier medical schools, and we acknowledge your role in achieving that reputation. A Penn Medicine education signifies more than high board exam scores. We are internists, specialists, pediatricians, emergency room doctors, surgeons, and more. We practice medicine in Philadelphia and other major urban centers, rural settings, and underserved areas throughout the country and on nearly every continent. We are clinicians, scientists, educators, and community leaders. We have doctoral and master's degrees in basic sciences, public health, bioethics, business, and education. We have managed practices, started companies, received NIH grants, and conducted clinical trials.

Above all we are compassionate, socially responsible, and grounded in the deep-rooted belief that doctors are vehicles for social justice. As Penn Med graduates, doctors, humans, we believe that social justice should not only have a place, but a central place, in the medical school curriculum. Dr Goldfarb, in spite of your remarks, we are proud to have received our medical education from Penn and will continue to use that education to best care for our patients by concerning ourselves with the social and biologic aspects of their health and by advocating for our most vulnerable patients. We are proud of the doctors we have become, and we hope you are too.

Sincerely,

162 and counting Alumni of the University of Pennsylvania School of Medicine

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