Before I entered HS, we lost our home in Rosamond CA and then lived in a motel for the summer. We had moved almost every other year before that, but in my mind, that was normal.

While living in the motel, my mom got sick. I asked my dad, ‘Can we take her to the hospital?’ And he essentially said, No, we can’t. We can’t pay for it. And we can’t even afford the gas money to go there. Meanwhile, my brother’s godmother passed away from cancer because she never had access to care. It was around this time, while witnessing these trade-offs, including giving up health care for gas money to go to work, the thought of becoming a doctor came to mind.

But when I entered college, I didn’t know what I was doing. I didn’t know who I had to talk to. I didn’t know that mentorship and networking was going to be important.

I solidified my decision to apply to medical school during my summer between first and second year of college when I did an internship. I helped save a life by doing CPR on a patient in the emergency department. Also during that internship, I worked with a very young cancer patient. She had just been given a late-stage breast cancer diagnosis. She started receiving chemotherapy and as the weeks went by, she lost her hair; her teeth; weight; almost everything you could think of. I would come back week after week and try to make her smile, bring her food and so forth—I was basically a nurse’s assistant. And I realized how much of an impact I could have on patients by just being there with them.

I have three brothers and my parents came from Nicaragua. I’m the only person in my family who had the opportunity to attend college. When I first got to college, I was excited. But as the weeks went on, I was very stressed in this new environment where, as a first-generation low-income student, I didn’t identify with the people around me. I felt pretty isolated, I felt alone. And I did not think I could succeed. I actually thought about dropping out.

That transition period was one of the biggest challenges I faced during college—that period where I didn’t believe in myself, I didn’t have the confidence. I was intimidated by everyone around me, especially my classmates who often reminded me of how unprepared I was when discussing high school advanced placement (AP) classes I didn’t have access to during high school.

But then a shift occurred: I reflected on the sacrifices my family had made. I thought about my dad working from morning until late in the evening, and how hard my mom worked cleaning homes and raising four boys. I also thought about the poverty I had seen throughout my entire life.

I told myself, what I’m doing here–trying to excel in class–is not easy as a student that feels alone, but my parents sacrificed a lot and I can do this!

I channeled strength from my parents’ experiences and used that as strength to move forward.

When my dad first came to the U.S. he worked on roofs for hours on end in the sun without much water and air conditioning. So when I would sit down and study for hours, I would think to myself,

‘Hey, I have water, I have food, I have a room, I have air conditioning. I can do this; and I have to do this because people are relying on individuals like me to help them one day.’

We don’t think like that enough when we’re in the process; we look at our grades and we think they reflect our value; but that’s not how it should be. You need to look at the entire situation. There’s probably a reason why you don’t have a 4.0. It’s not because you’re not smart enough, it’s because of a, b, c, d, e, f, g, h, I — all these reasons.

Students need to constantly remind themselves of that. Obviously work hard, study, do your work. But if the outcome isn’t an A, it’s not the end. There are other opportunities to make yourself a good applicant, including personal life experience. And your mission, what you are doing this for, matters as well. This is where the personal statement—maybe the most important part of the medical school application—comes into play. Your reasons for going into medicine, and your mission, are arguably more important than having a 4.0.

Grades, while important, are not the most important factor. They are simply one piece of your application that admissions committees will look at.

Like I mentioned, my parents came from Nicaragua and were initially undocumented immigrants. It wasn’t until I was five-and-a-half years old that they became permanent residents. But when I was born, they didn’t have status in the U.S., so we were prohibited from using the public programs available to poor families in the U.S.

When I was five years old, we got evicted from our apartment because I was sleeping on a mattress with two of my brothers; my baby brother was in a baby carriage; and my parents were in the bedroom, and you can’t have six people in a one-bedroom apartment, at least at that time in LA. So we were evicted and had to live in a shelter home after that.
 
From there, we moved every year and a half.

It wasn’t just housing instability that contributed to adverse childhood events, it was also the higher prevalence of violence. When I was in 5th grade, one of my friends had an older brother who was part of a gang in east LA and was trying to recruit members. And this friend asked me and a couple other of my friends to join the gang. I knew no better—I was 10 years old—and we all said, ‘Sure, why not?”

Thankfully I moved again after 5th grade, which meant I was away from that school district and I lost my friends. I don’t know what would’ve happened in middle school or high school if I had continued to be part of this gang.

We were on food stamps for many years of my life and even then, we had trouble with food, especially since we had four boys in our family.

Growing up, fortunately I didn’t have to deal with immigration issues, but my parents and family members did. I’ve had parents of my friends get deported.

The housing instability; the prevalence of violence; the food insecurity; and the threat of deportation experienced by those close to me showed me the reality of life. But that is the reason I will never stop in my mission to make life better for our most vulnerable neighbors.

I didn’t know any doctors or medical school hopefuls that I could ask for advice. But there were teachers along the way who supported me.

If I had to pick the most influential, it would be Caleb Schroeder, my calculus teacher, my trigonometry teacher, my cross-country coach, my track and field coach, and my mathletes coach. I saw his face a lot–I went to a small high school.

I met him freshman year when I joined the cross-country team. Initially, he believed in my running ability, my dedication and my determination because he saw that I’d come out and give it my all. But as I got to know him more over the years, he started not just believing in my athletic ability, but also in my academic potential.

He motivated me a lot. He always looked to me to set the example and be a leader: inside the classroom and outside the classroom. And when the time came to apply to college, he was one of the individuals I went to for advice.

So, your mentors may not look like you: Caleb Schroeder is white. I am not. He grew up in a rural part of California, in a working-class family. I moved around a lot and grew up in a very low-income environment. But he believed in me and pushed me. And I always say thank you to him when I do something in life.

Ever since I graduated from high school, he has invited me to speak with his students. He’s been a central figure in my life, and in my success.

It depends on where the student is in their education: if we’re talking high school, I would be proactive and seek out mentors that share similar interests. I didn’t think deeply about the idea of mentors until my senior year because colleges asked me about mentorship.
 
So, for HIGH SCHOL STUDENTS:
1) BE PROACTIVE about seeking mentorship. And 2) SEEK OUT SHARED INTERESTS
 
Mine were cross country and track. Running to me was CENTRAL—it was my love and my passion. Knowing that he (Caleb Schroeder) shared that passion brought us a lot closer and allowed our relationship to build. Months later, we were able to discuss the personal on top of the athletic and the professional aspects of my life.

FOR COLLEGE STUDENTS, it’s a slightly different story:
You’re less likely to join a basketball or cross-country team, or maybe even a band when you’re in college.

So the advice I would give there is to look to INSTRUCTORS for mentorship– some of my closest mentors in college were actually professors –again, my professors did not look like me, and maybe that was because there weren’t a lot of professors that looked like me. But also, I shared a common interest with the professors that I grew very close to.

When it comes to college it’s more about the academic interest.

When you take a class and you’re really interested—in sociology, let’s say–go chat w/ that professor, go to office hours. For example, I went to office hours and I chatted with one of my professors about the health component of the sociology class. I got to know her, and over the years, we grew closer together and she wrote one of my letters for medical school. Same thing with one of my organic chemistry professors.
 
I grew close to a lot of the professors who that taught organic chemistry. Primarily we would talk about organic chemistry, but secondarily we would talk about other things. One of my professors, an organic chemistry wizard, started going to the gym with me. These relationships were built on the foundation of the common interest in some sort of academic area, and then flourished into something else.

There are two dominant camps on a spectrum: there is one camp of health personnel who believe that we just need to be involved with the medicine; and when we’re in the hospital, only worry about the medicine.

The other camp says, ‘Yes, the medicine is important, but I’m concerned about health more broadly. And health is not just the result of medicine’; only about 20% of our health comes from medical care while 80% of our health is influenced by social factors.

If we are going to be medical students–professionals that are here for healing purposes, that want to do good—to improve the health of our society, we cannot be in camp one– we have to at least be on our way to camp two. We cannot be narrow-minded about our work—and say, ‘I’m just going to give you this pill, goodbye.’

Maybe that person is homeless and has nowhere to store their insulin. Maybe that person can’t afford healthy food when we tell them to buy vegetables. We need to think about those factors.

Some hospitals are working on this and screening for social needs. And maybe it’s not the med students’ job, but it’s someone’s job. And the med students should use that information to come up with a plan for the patient when they’re presenting the plan to the patient.

For med students in particular, we should: 1) when we’re in the hospital and seeing patients, create our plans around that person’s situation, not around any person’s situation, but that person’s situation– b/c they are unique in their own way and they will have limitations of their own; 2) LOOK AROUND the hospital and ask what can we be doing better for these patients?

Our hospitals in general don’t do a great job of addressing social factors. One individual can do something for a patient, but there are larger systemic issues that we need to consider in order to have a larger impact.

So I would challenge med students to look at the way their clinics and hospitals operate, and ask: ‘How can this be more inclusive? For example, how can this be better implemented for patients who don’t speak English?’

Med students are in a good position to think about these issues b/c 1) we come in with a little bit of naivety; and 2) we come in with a lot of enthusiasm– we aren’t tied to the status quo that we see within the hospital and health system in general. That is the second challenge that I would give to medical students.

Third, even when students are outside the hospital there are a lot of ways to improve health.

If you want to be a neurosurgeon and operate, that is totally fine. We need neurosurgeons, please do that; we need you. But even if you go down that route, you cannot dismiss what happens to a patient when they leave your operating room.

There are SO MANY WAYS to do this, but it’s about what most interests you.

Some individuals do policy work; they go to the state house and advocate for their patients on that level. Others are more interested in starting a food bank at the hospital.

And then some are more interested in the business side of things, where they can create something that will deliver more equitable technology, for example, to some of the populations that have unaddressed medical or non-medical needs.

If we are to be the med students and physicians we envision ourselves to be—those that care about the health of the patient—we should be thinking about what we can be doing better when we’re not in the hospital. To start, all of us can at least,

1) ACKNOWLEDGE that work needs to be done; and

2) DO SOMETHING to contribute—it doesn’t mean you have to be the one on capitol hill championing these issues, but maybe you can give your support when we need your signature to continue an eviction moratorium, for example.

1) My parents.

2) My siblings: I have 3 brothers. My older brothers had similar life experiences, or maybe even worse. When I look at them and what they’ve been able to accomplish, and how they’re raising a family, and working, and always trying to do better, I’m inspired. I get a lot of energy from that.

3) My friends: as a student who moved every year and a half to two years, I did not learn the value of friendship until later in life. Friends with whom you can be vulnerable and talk about anything are some of your best assets. I wish I had learned that earlier.
 
4) My patients: a lot of the patients and the people I’ve met, including those I’ve met on the streets, have inspired me. I’ve had an undocumented man come up to me and ask for help on the street. I sat down with him and he told me his story. I took his number down in case I found a job for him.

During my clinical years, three of my most memorable patients were: a homeless man with a new HIV/AIDS diagnosis; a Latino man who came in after being shot multiple times; and another Latino man who came in with potential liver failure and congestive heart failure, and had recently been incarcerated. One of them, weeks after surviving the gun wounds, introduced me to his family:

That’s my man, ‘es mi hermano’ and ‘este es buen doctor.’

These simple messages from patients and their families who are rooting for me provide me with so much strength and fuel to keep me going.