Michigan State University College of Human Medicine Department of Family Medicine

by Valerie Taglione

As I walked into the patient’s room, I broke into a cold sweat. The soon-to-be young mother had been profusely bleeding for over 24 hours, and it was time to take her to surgery. “There are too many late decels, we have to go now,” I heard my attending say. Late decels? I thought to myself. I looked to the patient, legs smothered in bright red blood with crusted edges, staring at the physician with wide, panicked eyes. “But I’m only 34 weeks. Will my baby be okay?” The physician paused, and looked deep into her eyes. “We’ll do everything we can to make sure that you and your baby are healthy.” She swiftly exited the room and looked up to me with a frustrated yet determined demeanor. “Great first day, huh?” she said to me as she walked past. I took a deep breath. This was not the way I thought my first day in the hospital as a third year medical student would begin.

As the patient was being prepped for her C-Section, I tried my best to stay out of the way (and not to pass out). I’m not sure I’d ever felt such intense worry; the lives of not one, but two patients were hanging in the balance. As the baby was rushed to the warmer, I was instantly drawn to managing her care. But what about the mother? She needed care, too. I felt torn, looking back and forth from mom to baby. That’s when I realized I needed to pursue a career that would put me in a position to help them both.

I have been interested in the field of family medicine since I was in college. I have always enjoyed working with the full spectrum of patients, from newborns to the elderly, from the healthy to the dying. In my first years of medical school, I attended multiple conferences in the areas of family medicine and primary care to learn more about the specialty and the wide variety of careers that family medicine can offer. These conferences opened my eyes to the many needs that family physicians fill, and how involved they are in the health of the community in which they serve. After my first year, I completed an externship with a local family physician to develop care plans for patients with multiple chronic illnesses. This was an overwhelming yet transformative experience for me as a student. I was able to see the frank and utter need of diligent primary care physicians in rural areas and felt a tremendous pull to help fill that need. After this experience, I wanted to learn as much as I could about primary care, and served on the executive board of the Family Medicine Interest Group in Grand Rapids. I also participated in a research project in the Department of Family Medicine that analyzed geographical gaps of care in prenatal and maternity services in rural Michigan, and was privileged enough to present this research at the North American Primary Care Research Group in Montreal, Canada. In addition, I returned to volunteering with a local hospice program to provide respite for full-time caregivers who look after their dying loved ones. This was something I had started doing in college to help expose myself to ill and dying patients, but I grew to cherish my time helping them in perhaps the most vulnerable point of their lives. Providing relief for family members who are going through such a tragic and taxing experience is extremely rewarding. I care deeply for this population of patients who have such meaningful and urgent needs.

Although I liked the aspects of family medicine, I became less certain of my career goals as I continued in my clinical rotations. Because I thoroughly enjoyed each clerkship, I found it difficult to narrow my options and struggled with the concept of giving up one specialty to pursue another. I wanted to do everything! I fell into a slump of discouragement; I became more distracted with completing assignments and meeting deadlines and less concerned with serving patients. Then I met a patient that changed everything. He was a local prisoner. I kept hearing murmurs and grumbles about “another prisoner”, and saw that he was treated differently and shown less respect than other patients. This was troublesome to witness, but oddly enough, it gave me hope. I felt something change in my gut and knew what I not only wanted, but needed to do. I need to help the vulnerable, the downtrodden, the people that no one else wants to help. I want a career in which I can give long-term support to the suffering and afflicted, one in which I can treat such patients with the dignity they deserve, one in which I can reach specific vulnerable populations and build lasting relationships with them, one in which I can witness each patient’s growth and healing over time. Instantly, a career in family medicine seemed to be a perfect fit.

I am interested in applying to TIP because I am very impressed with the Marquette Family Medicine Residency program. The curriculum emphasizes inpatient medicine more than most family medicine residency programs, which is highly attractive to me, as I thoroughly enjoy working in a hospital setting. In addition, I am from the Upper Peninsula and would like to train in a residency program that will prepare me with excellence for a career in rural medicine. I am passionate about returning to the Upper Peninsula to help ease the struggle that rural UP towns endure to keep physicians in the area. I find the TIP program appealing because it would give me the necessary stepping stones to pursue this important goal. In addition, I find it enticing that I could develop my own patient base as early as my fourth year of medical school. This would be an extraordinary learning experience and provide me with exceptional preparation towards becoming a distinguished physician. In addition to these, I am also very passionate about education and helping others to learn in a way that is most effective for them. Pursuing an additional area of study in Scholarship would allow me to engage in academics and incorporate teaching into my career as a medical resident. This would help me develop a well-rounded skill set as a not only as a learner, but also as a teacher and leader. I believe that teaching is perhaps an undervalued but essential component of medicine, as physicians have the opportunity to teach new things to their patients, families, medical students, residents, mid-level providers, and even other physicians. It would be a privilege to have the opportunity to incorporate that into my graduate medical education.

Pursuing a career in family medicine is a perfect fit for me. I can help the soon-to-be mother, the newborn baby, the dying patient, the afflicted, the prisoner, and the healthy. With a career in family medicine, I can do it all. Through TIP, I will be trained in the ways that will prepare me to be the physician I have been striving to become.