Things have changed in medicine over the years.
For that reason, incoming medical students at University of Pittsburgh School of Medicine (Pitt)—one of the 37 member schools of AMA’s Accelerating Change in Medical Education Consortium—wanted to put a modern spin on the traditional oath they uttered upon beginning their physician journey. So, in addition to reciting the Declaration of Geneva, they recited one that is specific to the nation’s tumult inside and outside the health care system.
“We start our medical journey amidst the COVID-19 pandemic and a national civil rights movement reinvigorated by the killings of Breonna Taylor, George Floyd and Ahmaud Arbery,” Pitt’s professionalism oath begins. “We honor the 700,000-plus lives lost to COVID-19, despite the sacrifices of health care workers.”
Pitt students recited the oath to their new medical school dean as they prepared for their physician journey. The authoring of a customized oath—written by a team of incoming medical students—was a chance for each to establish their physician identity. “We wanted to create an oath that reflected our internal beliefs,” said Nia Buckner, a first-year Pitt med student. “The themes and how we see medicine today in the 21st century. Not only do we care about the patient as a whole, but we also care about the social climate. We also care about how we influence others. It was important to make sure that we could see ourselves reflected in this oath and that it could withstand the test of time.”
There is a well-established tradition of first-year students at many medical schools creating their own custom oaths. The fact that the Pitt oath begins by making mention of the nation’s dual sources of strife is no accident.
“We all believe we are entering in the world of medicine at a unique time,” Buckner said. “Not only are we dealing with a biological pandemic but there is also a racial pandemic in the U.S. that is being revealed. We wanted to make sure that it was known to our audience that these are the times we are in and this is how we expect our medical careers to address them.”
By also reciting the traditional the Declaration of Geneva students had a view of medicine’s past. Their own oath offered their forecast of its future. “The way medicine was practiced when the Hippocratic Oath was made and the way medicine is practiced today are vastly different,” said Nerone Douglas, also a first-year med student at Pitt. “Doctors are no longer just doctors. We are no longer just focused on ‘You are sick, I’ll fix you—OK.’ We’re now in this new role where we have so many hats. We provide patients with more than simply medical care.”
Pitt’s customized oath reflects the many roles physicians play, with mentions of research, interprofessional collaboration, disparities in care and diversity among the physician body.
“Starting med school during COVID, it’s really hard to not think about the effect it has had on us,” said Nathalie Chen, who along with Buckner and Douglas was a member of the committee that wrote the new oath. “COVID has unveiled the deeply seated inequalities in our society.”
Going forward, the plan is for each incoming class at Pitt to write its own oath. Each class will recite it before they begin training, at the outset of clinical rotations and during graduation. The AMA has curated a selection of resources to help residents, medical students and faculty during the COVID-19 pandemic manage the shifting timelines, cancellations and adjustments to testing, rotations and other events at this time.
Launched last year, the AMA Center for Health Equity has a mandate to embed health equity across the organization so that health equity becomes part of the practice, process, action, innovation and organizational performance and outcomes.