“The Calling:” A Look Inside the Emotional Journey of Medical School

HARI SREENIVASAN: Bianna, thanks. Asako Gladsjo, Shauna Phinazee, thanks so much for joining us. Asako, let’s start with why this film? You follow a group of students through Einstein College in the Bronx, through kind of their trials and tribulations through, over a whole year. What drew you to this?

 

ASAKO GLADSJO: You know, it was something that, especially after the pandemic, I was really – you know, I live in Harlem. I live right next to the Bronx, and I saw how much medical inequity was at the same time that everyone was coming out every night to like bang their pots and pans. I thought, who, who is becoming doctors today? And, you know, one of the other things that, you know, was very concerning to me was I felt like a lot of the problems and what, why there was so much inequity was because of doctors coming from, you know, mostly coming from very privileged backgrounds. So it was really important to me, to focus on students who came from a really wide range of backgrounds and to see how it affected them to learn medicine in a community like The Bronx, which is one of the most underserved in America.

 

SREENIVASAN: Shauna, your journey is in the film. I mean, you’re one of the few students that are kind of profiled. You grew up sort of in the neighborhood in Harlem, and the Bronx, and you really kind of take us on a walking tour of some more of the painful parts of your life. And when did you think that you wanted to be a doctor?

 

SHAUNA PHINAZEE: Yeah. I wanted to be a doctor when I was 14 years old. It was this kid in, i, in my neighborhood. My little brother was four at the time that he was about the same age as my little brother, who had a congenital heart defect. And my mother would go visit him and just talk about all the sick kids at the time. And it just kind of really resonated with me. And I was like, oh, I need to do something about that in my naive 14-year-old way. And it just set me on his path to wanting to be a doctor. And that kind of just ignited that. He ultimately ended up passing due to his disease. But I think at the, it would, at the time, it was something that I thought I wanted to do and wanted to help.

 

SREENIVASAN: Asako mentioned this about who’s becoming doctors. And I wonder when you are in a medical school class, how conscious of you about who your peers are, what their life experience is, and what they’re gonna bring sort of to that examination room.

 

PHINAZEE: Yeah. As you know, we’re very underrepresented in medicine. Being a black person and being a woman too is very underrepresented, I think in my class. Which is better than most in the country at, being at Einstein. I was even shocked. I thought, going to the Bronx, I would it would be more diverse because it’s local. New York City is a very diverse city, but people all over the country applies to medical schools all over the country. So we were still very much the minority. But I think we did reflect a little bit more than a national average of people of color in med school. So it wasn’t a shock to me. Also did not go – went to a predominantly white college as well. So I was always used to being the only person representing my people in the room. And even that comes with its own burden. ’cause I feel like I’m one person. I can’t speak for everyone that looks like me or look close to me. So I just felt like when different conversations happen, they look to me in a room and I’m like, I don’t have all the answers. I can speak on my own experience, but I don’t.

 

SREENIVASAN: Asako, you know, according to the Association of American Medical Colleges, there’s an 11.6% drop in Black matriculants, 10.8% drop in Latino matriculants, and also about a 12% drop in just the incoming class. What are some of the factors that explain that?

 

GLADSJO: Well, I mean, I think we all have, can see in the news, you know, there’s been a, a very concerted attack on, you know, affirmative action and educational equity pretty much ever since the Civil Rights movement. And, you know, the very first attempt to have, you know, affirmative action for medical, or in that case, dental school was, you know, the backing case Bakke all the way back in 1978. And so this is not new, but it’s very depressing because there have been so many studies that have shown that, you know, when you have doctors from different backgrounds, they end up giving better care to people from, you know, a wider range of backgrounds as well. And I didn’t want to make a film where we just made arguments about it, because it’s very clear to me that the anti DEI mood that’s just taken over the country now is gonna make that problem worse.

But I felt like, let’s just see these students, if you follow these students and you see their work and you see their dedication and you see the challenges that they face, you will not doubt that these, all of these students are just as qualified as anyone else. I think that’s the, was the hope with making this film was that you would understand that it’s not, there’s this misconception that DEI brings in unqualified candidates, and that’s absolutely not true. DEI was made to level the playing field a little bit, to open the doors a little bit to other people who are going to excel in the field, but who haven’t had the privileges, the private tutors, the private schools, the parents who are doctors already. You know, all of these advantages that make it so that most medical schools are full of, you know, students from quite privileged backgrounds who have, you know, many of them have parents, at least one parent who’s a doctor already.

 

SREENIVASAN: Shauna, I mean, there’s a, there’s a scene in there with one of the students and his mentor’s an African American male, and he says, you know, the, the percentage of young black men becoming doctors has improved, but incredibly, very small amount.

CLIP

SREENIVASAN: When you were going through med school, was that, were you conscious of that? 

 

PHINAZEE: Yes. I think it’s really evident once you walk on campus and you start meeting your peers. And it is –Einstein, my class coming in was 183 people. And of that, if 20 was people of color, color and that includes Black and Hispanic students that’s the fraction that it was. And it’s just something that you just kind of know that it exists. Even like the doctors that we work with that are our professors or even the attendings we work with in a hospital not many of them look like, like me or look like anybody in my family. For the most part.

 

SREENIVASAN: So tell me a little bit about what made you, right now, I hear that you are pursuing radiology, right? Why radiology?

 

PHINAZEE:  It’s just something that I encountered on my third year. But radiology is just something I just fell in love with. I love – like I was a math person in college. I, I majored in math and just looking at the images I like, I like the images, I like the pathology. And then I did a breast radiology rotation, which is pretty cool because I think people think of radiologists, they think of them just kind of being in a dark room, not doing much not really interacting with patients, but that’s really not the case. And you can make whatever you want of it. You could be in a room reading, or you could be more patient-facing. You could be doing procedures.
So I felt like I just had just the variety that I wanted in a career. And if my priorities change as I grow go older in a profession, I think I can move through the space in a way that kind of fits my life as I go on.

 

SREENIVASAN: Asako, there’s a powerful moment in the film where really the, the, the students are coming in kind of their first day of cadaver lab, as a filmmaker, how did you choose which moments? What were the things that you were looking for? Because I’m sure you had a lot of hours of video that we didn’t see.

 

GLADSJO: Yes, there was definitely a lot of hours. I will say. You know just sort of the complication of shooting in any medical setting is, is  there’s a lot of permissions you have to get, like every time you see a patient that was, people were contacted ahead of time, they had to sign HIPAA releases as well as appearance releases. It was quite complicated. So we didn’t – we had a lot with our students outside of patient settings. But in terms of just getting to know the students, what we also, it was important to sort of show these different aspects of it. The, the, the challenge of how much work there is, the realization that no matter how well you ace your tests, if you don’t know how to talk to a patient, you’re not gonna necessarily be a good doctor. And if you are worried about yourself academically, you might actually, you know, discover that your skills making people feel at ease are gonna be the ones that really make a difference. 

 

SREENIVASAN: Shauna, you know, you and the other sort of main character, you kind of have this fork in the road and very sort of justifiably so. She wants to stay in the Bronx and she wants to match with the hospital, and she does it, you know, in the Bronx, and you’re like, I’m, I’m ready for, to see the rest of the world. Right. And you are now at Duke. Why, what was, what was the motivating factor for you to kind of spread your wings?

 

PHINAZEE:  Yeah. It was definitely a decision that was not taken lightly. It’s something I always saw myself as a doctor and practice in New York and helping my community. But I think once my, my brother was killed like right before starting med school, I felt like I gave like New York enough of my energy and time and didn’t want my kids to kind of grow up in the same neighborhoods and environments. Even if I was to become a doctor and be able to move out of different neighborhoods within New York City, I feel like it’s still so accessible and in my family, like history is so accessible. And I just feel like it was time for me to kind of move and into a different space in my life. And I thought I, I kind of landed at North Carolina ’cause I’m like, it’s still far enough south where the weather’s nicer. And I’ll still have the, still close enough that it’s a quick flight or, or it’s drivable back home to New York City where most of my family lives. So I think I, I, I like, I gave New York a a lot of my time and emotion and energy and I think I don’t want my kids to, to have to even experience it or even know of it for the most part. Yeah.

 

SREENIVASAN: Yeah. Not to mention it’s a very good program that you’re in. So congratulations. 

 

PHINAZEE:  Yes, for sure. Yes, for sure.

 

CLIP

SREENIVASAN: Asako, you, you kind of weave these kind of personal narratives into the story a little bit. Why did you feel that was important for us to kind of get to know the characters’ back stories, get to know kind of them and their families? ’cause we have multiple scenes of that.

 

GLADSJO:  I think a lot of people feel alienated from the medical system for a lot of reasons. And a lot of it has to do with the insurance and the way that, you know, you know, when, when something terrible happens to a family member, you know – I had a, one of my daughters was hit by a car and the first way I knew about it was a hospital called asking for the insurance. And so there’s a lot of ways that you blame the doctors as a patient. You think the doctor is just there to make money, that they don’t care about you, that they’re wasting your time. And just the hoops that you have to jump through to get things covered and all of that. It’s easy to not see that the doctors come to this profession, that it’s actually an incredible devotion to caring for others that motivates them.

And one of the ways I felt like you really could feel it was when you saw them outside of class, outside of those medical settings, that you could feel that this is a person that their whole life has brought them to this point, that they’re willing to make these sacrifices, to do this incredibly hard work. And it’s, it’s not, it’s not like doing other kinds of jobs. I mean, it is a job where you are committing yourself. That’s why it’s called “the calling.” That – and so I think that for for those of us who aren’t doctors who are just in the, in the large patient community it was a way to understand who are the doctors that, that are, that are caring for us and you know, why it matters, which to understand that they can come from all kinds of backgrounds and be really a great doctor. 

 

SREENIVASAN: So, Asako, what’s the reception been since the film’s been out?

 

AG: It’s been great. I mean, I, I have been surprised at how, you know, moved people are, I mean, of course doctors are thrilled by it. You know, interestingly, I just came back yesterday from a film festival in Cuba where there were Cuban medical students and a faculty member from the medical school there who, I mean, they were thrilled. They loved seeing it because they have a lot of complaints about the way their medical system works. But, you know, they have single payer and it’s, they’re very under-resourced, but medical education is free, and they’re known to have very good doctors. So it was just fascinating for them to see that, you know, something that they kind of take for granted that if you wanna be a doctor, you can just go for free. To see that, that the hoops that these students were jumping through because they were so committed to caring for patients and that that was something, you know, they were really moved by. I mean, there were tears.

 

SREENIVASAN: Shauna, it comes as a postscript in the film, but just really after you graduate is this unbelievable philanthropic gift. The tuition will now be free at Einstein for every medical student coming in. You did not benefit from that, but what is the change that you see possible?

 

PHINAZEE:  Yes. so I do, I do hope that the change allows for students like me to now be able to not worry about the financial burden of medical school. And Einstein has a great mission for medical school, and I think that mission allowed me as a student to get accepted into Einstein. And I just would love for that mission to keep them true to that value of making, help in a diverse medical system. I know we’re in the times where like, like Asako was saying that DEI is under attack and people’s missions statements are changing a little bit to maintain their federal funding. But I do hope that this is something that they still allow them to be true to their character and their mission and admit students like me who wouldn’t have a chance otherwise to get into medical schools.

 

SREENIVASAN: Yeah. Asako we’re having a conversation on the day that these students match. And you captured that for this particular class and this group of students that you were following. 

 

CLIP

 

So what was that like?

 

GLADSJO: I mean, it was, it was exciting and it was also, you know, for my core crew who had been, you know, bothering these students for an entire year, <laugh>, we were just as emotional. We were crying. We saw each other. Like I saw, you know, the associate producer, the cameraman there were like tears everywhere. (26:04): Everyone was like blowing their noses. ’cause We were so excited. And I will say, you know, when I cast the two sort of main fourth year students that we follow that are the core of the film I met them when they were in their third year and, you know, we sort of imagined following them over this year. I, I could never have predicted that they would both get their top choice residency because, you know, not everyone does. I just wanna be sure that people understand that. The fact that they get the ones that they wanted the most and that they told me repeatedly they wanted the most was kind of amazing.

 

SREENIVASAN: Yeah. Yeah. This is it, it was really a wonderful kind of crescendo to the film, just emotionally as well as just kind of as a narrative arc. But so congratulations on that.

 

GLADSJO: Thank you.

 

SREENIVASAN: Filmmaker, Asako Gladsjo, and Dr. Shauna Phinazee. Thank you both for joining us.

 

GLADSJO:  Thank you.