Advocacy @ UC: From Public Policy Major to Medical Student

Sara Constand, first-year medical student at UCCOM

For UCCOM first-year medical student Sara Constand, participating in health policy research as an undergraduate seemed like the most rational way to bridge her lifelong desire to be a politician with her burgeoning interest in medicine. Constand, a 2018 alumna of Duke University, researched policy regarding physician-patient palliative care discussions under the supervision of Dr. Donald Taylor, Jr. within Duke’s Sanford School of Public Policy. For our third post in the Advocacy @ UC series, we talked to Sara about her research experience and about what makes her move medicine.

How did you get involved in policy research?

Until my senior year of high school, I thought for sure that I wanted to be a politician. I was going to go to law school, I was going to be on this track, I was going to work for the state. I was going to be the first female president. But during high school, I realized that I really love science and wanted to become a doctor. I thought that public policy was a really good intersection of those interests and decided to major in public policy and minor in global health studies at Duke.

What did you research during your time at Duke?

In 2009, there was some drama surrounding a proposed change to the Affordable Care Act that was coined the “death panels.” Some politicians argued that allowing physicians to be reimbursed by the government to have end-of-life talks with their patients was like allowing doctors to judge who in society was worthy of living. For my research, I went through a public database where anyone in the public could comment on the legislation before it was introduced to Congress. I went through thousands of comments and characterized them based on their support for or against the bill. I also looked at the demographics of the people making the comments to try and find from where these deep-rooted opinions on either side of the change we’re coming.

What were the results of your research?

Ultimately, I found that most of the positive opinions for the change came from the scientific and medical communities and most of the negative opinions did not. I think [the negative opinions] were rooted more in emotion. But these conversations are important. They enable doctors to let patients know the pros and cons of continuing treatments like aggressive chemo that might extend life for a few months but at a substantially lower quality.

What was your experience like as a public policy major hoping to apply to medical school?

My entire undergraduate career I felt like I had two separate communities of learning. I learned so much for my peers in the policy studies that had absolutely zero interest in science. Learning from every point of view was incredible. The diversity of thought in the public policy school was really important to influencing who I am today. I think it’s made biochemistry a little more tough in medical school, but it was definitely worth it.

Has your research influenced how you hope to practice medicine?

I think this research has definitely influenced what kind of doctor I want to be. I want to go into emergency medicine because I think it’s one of the most equitable specialties. Lots of doctors only treat people from certain demographics, and, in some cases, just the upper echelons of society. But emergency medicine doctors see everyone. In the same hour, a doctor might see a billionaire and someone experiencing homelessness. Being an EM physician, you have to really be aware of the system in which you’re operating in order to care for everyone that walks in the door. In the emergency setting you truly are helping someone at the most fundamental level, regardless of bank account balance or address.

To read more about Sara’s research, go to this link.

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