The When and Why of my Good Trouble in Medical Education

From the 8/21/2020 newsletter 
Personal Opinion / Perspective 
 
The When and Why of my Good Trouble in Medical Education

 
Jeff Fritz, PhD – MCW-Central Wisconsin (MCW-CW) faculty member

 
Dr. Fritz, a founding member of the MCW-Central Wisconsin faculty, finds inspiration in old books and documents that push us in the direction of  “good trouble.” In this essay, he points to some areas where he believes we need to make changes …

 
 

I enjoy old documents. One of my hobbies is finding old books – like ones that explain medical treatments – with copyright dates prior to 1900. I keep searching for older and older volumes of the drawings by Dr. Frank Netter and the first editions by Dr. William Osler. 
 
My family asks me why I keep exploring for things that could be found on the internet. For me, holding these works provides inspiration. Older documents let me adopt the perspective of the writer, give me a glimpse of their experiences, and encourage me to continue to look for solutions to age-old problems. 
 
Often, older documents tell me when and why I need to act – they illuminate those areas where I need to get into “good trouble.”  Two documents of which I hope to someday add older copies to my collection are the Declaration of Independence and the Constitution. The Declaration reminds me to take a stand and join the cause for those experiencing limitations to “life, liberty and the pursuit of happiness.” My favorite phrase in the preamble is “it is the Right of the People to alter or abolish [the government], and to institute new Government, laying its foundation on such principles and organizing its powers in such form, as to them shall seem most likely to effect their Safety and Happiness.”For me, this is a call to action to serve those around me when they share their personal struggles, injustices, or failures to overcome institutional roadblocks. The Declaration of Independence guides my energies when I need to get into good trouble. 
 
In addition to these documents telling me when to get into good trouble, the Constitution begins by telling me why. “We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defense, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.” This tells us why we expend our energies when it is time to get into good trouble. I think it challenges us to form more perfect institutions, improving upon our structures so that those around us can better flourish.   
 
What does my personal hobby have to do with medical education?  As a faculty member on a regional campus, I get to work at a medical school while still remaining in my rural community. Twenty years ago, my spouse and I left our familiar academic environment of Nashville, Tennessee to support her rural medical practice and to focus on our growing family. Trust me, I thought the opportunity to engage with medical students was a thing of my past! But thanks to many courageous leaders willing to develop regional campuses and get into good trouble, I can both support my spouse’s pursuit of happiness and, once again, pursue my own dream as a medical educator. I want more people to experience the joy I experience as an MCW-CW team member and as part of the Kern Institute faculty. 
 
As I begin my fifth year at MCW-CW, I feel it is time to respond to concerns raised by our learners, inform our leaders, hold myself accountable, and create some good trouble to benefit both our learners and our institution. 
 
Here are areas where I hope to make some good trouble this year.
 

 Area 1 – Admissions
I have been on the MCW Admission Committee for four years and will encourage our team to more fully embrace the challenges to transform our admissions process. We must admit cohorts of learners that more dynamically represent the communities we serve. 
 
To my friends on the Admissions Committee and within the Student Pillar at the Kern Institute: I know the energy it takes each year to screen, interview, and admit a new cohort of students, but I challenge us to get into some good trouble and develop a better system that will lead us to becoming a more inclusive, antiracist institution. Hold my feet to the fire and hold me accountable – let this year be the year we develop a more robust, holistic, and inclusive admissions process. 
 

Area 2 – Curriculum
My primary role at MCW-CW is to assist instruction throughout the first year of our current foundational science curriculum. Over the past four years, I have watched learners succeed as well as struggle. I feel our curricular structure could do more to ease the suffering of our students. I have watched our institution embrace the good trouble of student, faculty and staff well-being and make great strides in a short period of time. However, we have so much more to do in revolutionizing our curriculum to meet the need of our learners on each of our campuses and those we would like to invite onto our campuses as learners. 
 
To my friends on the Curriculum and Faculty pillars at the Kern Institute: Now is the time we put forward a curricular design with the flexibility and inclusivity to ease the suffering of our learners on all of our campuses and helps them feel supported, safe and justly treated.  
 

Area 3 – The cost of medical education
I’d also like to see us embrace a new way to support our students with the cost of medical school, but I fear this is out of my sphere of influence ; after all, you can only throw the tea into the harbor off of the boats onto which you can board. While I explore a more direct means to influence our financial approach to medical education, I challenge us all to expand our funding horizons as an institution. We need to take up the good trouble of eliminating the hurdle and fears surrounding the cost of medical education.

We need to acknowledge how these costs limit our ability to fully develop a diverse and inclusive cohort of learners and faculty. We need to tackle the cost of medical education, both financially and culturally, as it continues to exclude those that remain outside our community. I’m looking for ways to dump the tea overboard on current system and explore a new and better way to constitute financial aid.