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Class of 2008 Graduation Ceremony Commencement Speech by Dr. Alma Littles, Senior Associate Dean for Academic Affairs

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May 17, 2008

Good Morning,

I consider it a privilege and an honor to have been invited to share this moment with the FSU College of Medicine’s Class of 2008. I thank you for the opportunity. I would also like to thank Dr. Harris for his support, and I join you in thanking him for staying on as Dean of the College of Medicine throughout your tenure as students here. You are the Class who moved into our newly constructed COM building in the fall of 2004 as first year students and shortly after that we had our site visit which led to our eventual full LCME accreditation. That was a really big deal for those of us who had been around a while.

Of course, you were just enjoying the fact that you’d successfully made it through your first Doctoring Class and Gross Anatomy, and were hoping your second semester would be just as successful. You had no doubts about our eventual accreditation status, as was evident in many of your profiles where you almost unanimously state that you chose to come to the FSU COM because you believed in our mission to educate and develop exemplary physicians who practice patient-centered health care, discover and advance knowledge and are responsive to community needs, especially through service to elder, rural, minority, and underserved populations.

As you complete your medical student careers and officially enter the profession, I want to share a few words about who you told us you were when you started and who we expect you to become, remembering that “to whom much is given, much is expected”. We have equipped you with some of the most advanced, high-tech, cutting edge medical knowledge and skills available in the world. But what will make the difference in your success as physicians is what comes from your heart, calling on those qualities instilled in you early in life from your family and others around you.

You came to us from all sorts of backgrounds:

A nurse assistant originally from Turkey who was involved in fundraising to help families from a devastating earthquake in Istanbul and whose experience with medical hardships in his own family gave him tremendous inspiration to become a doctor;

A youth basketball coach and rock band member originally from Brazil who once served as a missionary in East Los Angeles and chose to become a physician “to help those who could not help themselves in their most vulnerable times”;

A basketball coach for the Junior Magic League in Orlando who chose to become a physician because of the opportunity to touch people's lives;

A captain of the University of Florida’s Women’s Lacrosse team who wants to serve her community and help others;

A medical technician who spent two weeks in Honduras working with the Mosquito Indians, spent two months in Belize working in a primary-care clinic and two weeks in Nigeria at a diabetes clinic, inspired by his physician father to become a doctor;

A member of FSU Women’s Basketball team who was motivated to pursue medicine after serving three years as the public relations lead on Florida’s youth anti-smoking program;

A gentleman born in Hong-Kong, who mentored and taught piano and music theory to an underprivileged elementary school student;

A licensed medical technologist who’s life goals are to educate and to heal;

A bass guitarist who participated in a Mission trip to Belize where he played with children and helped build churches;

An Army medic; A medical assistant and former Girl Scout troupe leader; A soccer coach for children with diabetes; A University of Miami’s women’s varsity crew team member; A certified surgical technologist and certified tissue bank specialist; A research assistant and personal trainer who grew up on a farm in the woods; A Desert Storm Veteran of the US Army; A Nursing assistant, who ran cross country and track and participated in mission trips; A pediatric Registered Nurse; A member of the United States Air Force, K-9 police officer, and personal fitness trainer; Many volunteers for Habitat for Humanity; Former middle, high school and college tutors; Many who were inspired to pursue medicine after witnessing illness in family members, bystanders, or on mission trips.

In addition, eight of you participated in our College of Medicine Outreach programs, either SSTRIDE, MAPS, or Bridge.

The diversity among you has enriched the entire FSU COM and will serve to make you all better physicians. While what you brought to the COM table was diverse, you will all leave with the same credential – an MD degree from the Florida State University College of Medicine. I had the opportunity to give you an initial welcome to the profession when you received your first white coats in August 2004 and I am even more privileged to welcome you now as you receive your MD degrees and prepare to leave today as colleagues in the profession.

The degree you will receive today is much more than a piece of paper. It is much more than initials behind your name. You were reminded many times in your medical school career about the expectations that society would have of you as medical students. Those expectations will dramatically increase as you leave today with your degrees. The medical profession is a calling that is devoted to health, healing, caring and compassion. Society has entrusted us with its health and well-being and with that trust comes a responsibility that is unmatched in other professions. We are expected to meet higher standards of knowledge, skill, compassion, ethics and service.

You now join, what we still believe today, as even Hippocrates declared, is the most noble profession in the world. It is a profession filled with challenges and opportunities, moments of disappointment, years of joy. Your patients will share their innermost thoughts and life experiences with you, things they won’t share with anyone else, not parents, not children, not spouses. You get to share the joys of the birth of a baby, guide others through periods of trauma and illness, and when medicine and science can offer no more, assist your patients in dying with dignity.

Class of 2008, we have equipped you with excellent preparation for the practice of medicine. No doubt, while you may be able to put them at rest today, you have fears of what the future holds for you as, in a few short minutes, everyone begins to address you as “Doctor.” You undoubtedly have some trepidation regarding your entry into residency training.

I encourage you to remember what that hesitation feels like and never lose sight of it. You must never become too complacent with your knowledge base and skills. Medicine is an ever-changing profession and you must forever be a student for the sake of your patients.

The uncertainty you feel is normal, but I assure you that you have demonstrated the ability to succeed and we are certain you will become some of the best family physicians, internal medicine physicians, ER docs, psychiatrists, radiologists, pathologists, surgeons, ophthalmologists, urologists, dermatologists, anesthesiologists, pediatricians and obstetricians/gynecologists wherever your career takes you.

Today marks the beginning of a new identity for you. No matter what you choose to do in your future careers, whether you see patients, teach medical students or residents, work in a research laboratory, work in health policy or choose not to practice medicine at all, being a doctor will forever remain a part of your central identity. Over time, it will likely become the most important part of who you are.

You will be recognized that way, no matter how hard you try to avoid it. At the grocery store, at church, at the barber shop, hair salon, college football games, shopping malls, your childrens’ plays at school, your son’s baseball game, your daughter’s soccer game, on the beach – someone will come up to you and say something like, that’s Griffin Gaines, he’s a doctor, you know; or let me introduce you to my daughter, Nikita Wilkes; the doctor, or here comes Dr. Alci, let’s ask him what’s wrong with your hip. There will be no escape. So my advice is, embrace it and don’t try to fight it.

It defines you not just to your patients, but to your family and friends who will always consult you first for every health issue, whether it’s in your field of expertise or not. They may not always believe or accept what you tell them, but they will always consult you. Even more, it will define you to society as being someone who is quite distinct, someone who has the highest of integrity and someone they can trust. You will be the one governmental officials will call upon to offer expert advice on medical issues. Please answer their call if you get it.

The document you receive today will be a symbol of a much deeper commitment to promoting our expectations of professionalism, humanism and compassion. You may or may not remember my words from before, so I remind you again that it’s not all about YOU anymore.

You must remain committed to maintaining life-long learning skills, to putting the interests of your patients above your own, to striving to treat patients with the highest possible standards, to respecting the values, culture, and dignity of every patient and to working respectfully with other health professionals to ensure the best care for your patients.

I’ll close with just a few comments about the current challenges the medical profession faces today. Despite increasing use of diagnostic technologies and advancements in therapeutic abilities, we continue to witness increasing disparities in the delivery of health care.

Despite spending more on health care than many other developed nations we have one of the highest percentages of uninsured citizens, leading to increased morbidity and further creating disparities in infant and maternal mortality and other preventable diseases.

The threats of medical liability claims are constantly present. Reimbursement isn’t always what we feel it should be.

These challenges lead some to become disillusioned and cynical. I challenge you to beware of this pitfall, and always remember whether you’re in the Emergency Room, Operating Room, Delivery Suite, or exam room and the exam door closes, and it’s just you and your patient, this is a profession of compassion, integrity and service.

I will quote Dr. Francis Weild Peabody, a professor of Medicine at Harvard Medical School, among others, who in the early 1920’s wrote a series titled “The CARE OF THE PATIENT”, where he stated that “Time , sympathy , and understanding must be lavishly dispensed , but the reward is to be found in that personal bond which forms the greatest satisfaction of the practice of medicine”.

He ended it by stating, “One of the essential qualities of the clinician is interest in humanity, for the secret to the care of the patient is in caring for the patient”. In other words, your patients won’t care how much you know until they know how much you care.

From the time I was in second grade, I knew I wanted to become a doctor. There were many, given the underserved environment I was in, who thought that was an impossible dream. However, I never stopped dreaming it. And it was the support of family members, church members, teachers and friends who encouraged me to continue on that made it possible for me to have my dream fulfilled. Many of you likely have similar stories of overcoming obstacles to get where you are today.

I encourage you to never forget who those individuals are and to let them know how much you appreciate their support along the way. I also ask that as you go on to do great things in your careers that you never forget those who will be coming behind you and need your support and encouragement to succeed as well. Remember “to whom much is given, much is expected”.

In closing, as Alan Kay, American computer scientist, researcher and visionary once said, “The best way to predict the future is to invent it”. Therefore, I admonish you to go out and face the challenges of the profession head-on and do your part to make the necessary changes to provide the best quality care to all citizens. America's healthcare and that of the world is depending on each of you making an impact.

CONGRATULATIONS!