At the annual White Coat Ceremony, UW’s incoming medical students receive their first doctor’s coat and recite the Declaration of Geneva, a modern interpretation of the Hippocratic Oath.
As a medical evacuation pilot in Afghanistan in 2014, Denis Alfin transported injured Afghan soldiers from the battlefield to a NATO hospital. It was his first exposure to medicine.
“My role was more like a bus driver; it was the medic in the back of the helicopter who was providing care,” he explained. “But I did get to check in with patients and their doctors and nurses when missions were over. Seeing the trust that physicians were able to develop with people from wildly different backgrounds made an impression on me.”
At 28, Alfin thought he was too old for medical school. He was also establishing a career with the Army. But several years later, his life took a sudden turn when his brother, an FBI special agent, was killed in the line of duty.
Alfin, who had been completing a three-year rotating faculty assignment at West Point in New York, requested a “compassionate reassignment” to south Florida, where he had grown up. The Army assigned him as the deputy commander for a primary care clinic at U.S. Southern Command in Doral, Florida.
The experience inspired him to change paths and become a doctor.
“In the clinic, I saw what doctors could potentially do for someone through empathy and by sharing their knowledge at a level that the patient can digest and understand,” Alfin said.
“That’s when I decided I definitely wanted to go to medical school.”
This fall, at age 38, Alfin joins the class of 176 incoming medical students at the University of Wisconsin School of Medicine and Public Health to begin a challenging, four-year MD program. His journey is an example of the “ikigai” that Dean Nita Ahuja spoke about as she welcomed the incoming class — her first, as dean — at the annual White Coat Ceremony at Shannon Hall in Memorial Union on Friday, August 22.
“Ikigai is a Japanese concept that translates into ‘a reason for being,’” she said. “It is the why behind what you do. It’s about discovering what you love, committing to excellence, and doing something the world truly needs.”
Medical training is rigorous and lengthy, so a strong “why” can help students power through challenging courses, clinical rotations, and the selection and pursuit of their specialty.
First-year medical student Yihana Meléndez Alejandro discovered her “why” growing up on the 20-mile-long island of Vieques, Puerto Rico.
I know I can’t fix everything, but I can contribute to a solution.
- Yihana Meléndez Alejandro
In her hometown of Isabel Segunda, there are no stoplights. There is no hospital. Physicians staff the health clinic on a rotating basis. Those in need of urgent care must call for helicopter transport to San Juan, on Puerto Rico’s main island. That can take hours, Meléndez Alejandro said.
“I know people who have died, waiting for the helicopter,” she recalled. “When my mother was pregnant with me, she had to travel by boat to the main island to deliver. Twenty-three years later, there is still a lack of access to health care on Vieques.”
Meléndez Alejandro also cited the higher-than-average rates of cancer, diabetes and other diseases on an island known for its snorkeling and quiet beaches but also for its history as a bombing range for the U.S. Navy until 2003. Studies have shown significantly higher levels of lead, aluminum, arsenic and other toxic chemicals in Vieques residents, as compared to people on the mainland.
“I grew up seeing these health issues on Vieques,” she said. “That is why I want to study medicine. I know I can’t fix everything, but I can contribute to a solution.”
Meléndez Alejandro missed her tight-knit family when she went to the University of Puerto Rico in San Juan for college, but that did not stop her from completing two research training programs as an undergraduate: Howard University’s Summer Research Early Identification Program in Washington, D.C. and Harvard University’s Summer Honors Undergraduate Research Program (SHURP) in Boston, Massachusetts. At Harvard she was accepted into the first cohort of the Harvard Equitable Access to Research Training program (a specialty track within SHURP), working with pediatric oncologist Dr. Vijay Sankaran.
Because her grandfather has a cardiovascular disease, Meléndez Alejandro is considering cardiology as a specialty. She intends to return to Vieques to help improve care there, after finishing her medical training.
“I am the only one I know from Vieques who is studying to be a doctor,” she said. “A lot of people at home are proud of me and are counting on me. I love being a mentor and sharing my knowledge, but I want to make sure I know everything I need to know before I go back.”
After completing the MD program, most graduates enter a residency program, depending on the specialty they choose. For the 10 incoming students accepted into the Medical Science Training Program (MSTP) each year, the educational journey is longer. MSTP students receive integrated graduate training in scientific research and clinical medicine, culminating in a combined MD-PhD degree, which typically takes eight years. Most will then go on to pursue a residency.
Troy Fisher, an incoming MSTP student, will pursue an MD and a PhD in immunology. His research will focus on mass spectrometry proteomics, a powerful method for analyzing proteins to gain insight into disease states.
Fisher’s “why” stems from a deep desire to discover cures through research. He is not one to shy away from a challenge.
Growing up in the agricultural community of Garden City, Kansas, Fisher worked on his uncle’s dairy farm in the summers, starting at age 13. The early hours were grueling for a teenager, but Fisher said the job instilled in him the value of hard work.
“There were never any excuses not to get up and milk the cows,” he said. “My uncle would always say, ‘The cows don’t care if you’re not feeling well.’”
Among eight siblings, he is the oldest of six boys and has two older sisters. His “rowdy upbringing” made him a natural fit for wrestling, he said, but it was hard work and commitment that earned him a wrestling scholarship to Northwestern University.
“In wrestling, it’s all about the prep you go through to get to the match,” Fisher said. “You have to choose a healthy lifestyle. The dairy farm taught me to work hard, and wrestling taught me to take responsibility for my success or failure.”
Injuries piled up for Fisher at Northwestern, resulting in nine surgeries. During that challenging time, he developed a strong relationship with the team physician, Dr. Jeff Mjaanes, and began considering a career in medicine.
“I learned very quickly that a good physician can be a very valuable and impactful person in your life,” he said.
Fisher began volunteering in a hospital, and the experience fueled a drive to improve care through research and discovery.
“The more we can understand about disease, the closer we can come to finding cures and the better we, as medical professionals, can treat patients,” he said.
Fisher landed a research opportunity in Dr. Neil Kelleher’s lab at Northwestern, where he worked on “top-down” mass spectrometry proteomics. The technique allows researchers to measure the weight and structure of intact proteins and detect subtle changes that can indicate disease. Top-down proteomics is a challenging field requiring advanced training on complex instruments and expertise in data analysis. UW–Madison is among a select but growing number of institutions with the tools and expertise to advance discovery in the field.
“I’m very excited to join MSTP,” said Fisher. “I have a long road ahead of me, but if I stay focused and work hard, I think I’ll be successful.”
Seventy-five percent of the entering class of 176 medical students are Wisconsin residents, and more than half are women. Students’ ages range from early twenties to age forty.
Banner image by Media Solutions
