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What my former career as a pipefitter has taught me about medicine so far

“That’s just a little blue-collar ingenuity, my friend” said “Junior” as we all sat there dumbfounded. I was the foreman of a pipefitting crew at a large semiconductor plant in Oregon. Junior was a traveling pipefitter from Florida and a veteran of the trade. For the past two days, we had been racking our brains attempting to rig a difficultly large spool of pipe so that we could make a weld. Our attempts had all failed. But how? We were all certified in rigging and had done this thousands of times. Junior joined our crew earlier that day. When he saw that we were struggling, he walked over, nonchalantly, and changed our approach in a way that none of us had seen before. It worked. We had been too focused on approaching the problem from a single perspective – we were unable to take a step back and reassess our methods.

What Junior described as “blue-collar ingenuity” is really just a solution to the concept of functional fixedness; a cognitive bias where utilization of an object is limited by tradition, preventing creative alternative uses that may better solve a problem. Junior, like plenty of my former pipefitting colleagues, did not have a rigorous academic background. The profession does not require stellar test scores or even a high school diploma. Rather, their lived experience and work ethic helps shift the mindset from “we have always done it like this” to “why don’t we try it this way?

At the age of 28, I left my career as a pipefitter to pursue the profession of medicine with the hopes of providing gender-affirming care for the transgender and gender non-conforming communities. Despite the efforts I put into understanding the road to medicine, the decision to change careers was a major leap of faith. I am the first of my family to attend college and lacked support when it came to navigating the intricacies and nuances of becoming a competitive applicant for medical school. I tried to immerse myself in opportunity, taking on multiple roles in research, community service, and mentorship. When the time came to apply to medical school, I felt that I amassed an application that would give me a fighting chance as a 31-year-old applicant from an unknown state school. I was taken aback when every single medical school interviewer homed in on one aspect of my application – my nine years working as a pipefitter. Frankly, prior to submitting my application, I was debating whether or not to even include the experience on my application since it was not medical in nature.

During my first medical school interview, I waited nervously in the room with the other applicants – these were seasoned veterans of the interview trail at this point, discussing which Ivy League institutions they had already interviewed at and what swag they acquired along the way. My interviewer approached me from the pastry table and without introducing himself said “I love that you included your experience as a construction worker.” From that point, my interviews across the board primarily revolved around an experience that I nearly omitted.

I found parallels along the way between my experience as a pipefitting apprentice and as a medical student. What is medical education if not an apprenticeship to learn a skilled trade? As a pipefitting apprentice, our curriculum revolved around on-the-job training with skilled journeypeople. We spent between 40-80 hours a week in the field. We had didactics, practicals, and licensing exams. Like clerkships, our evaluations were based on the subjective opinion of our preceptors. We were even hazed under the guise of “building character.” Most importantly, upon completion of our apprenticeship, we were tasked with training the next generation. Despite these similarities, the starkest difference was that of functional fixedness.

Medicine is a profession that prides itself on tradition in both an educational and practical sense. Granted, during my pipefitting classes, we never learned the name of the person who invented the tungsten inert gas welding machine, but we were never told to perform a job a certain way because “that’s how we’ve always done it.” Medicine prides itself on being evidenced-based. We have entire classes dedicated to the importance of this topic. It was a shock to see the pervasiveness of functional fixedness in healthcare as a medical student. In many instances, the culture of the institution appears to dictate the practice of medicine in the absence, or even in opposition, of evidence.

New perspectives on problems are arguably what drives innovation. Historically, the field of medicine has been comprised of a homogenous group with similar backgrounds. One in 5 medical students have a parent who is a physician. Over half of all medical students come from families whose income is in the top 20th percentile of earners. Even today, where undergraduate advisors promote the idea of scheduled gap years, the average age of medical school matriculants is 24, leaving little room for experiences outside of medicine. A diversity of vocational experience in a class provides unique perspectives to problems. My experience as a pipefitter will vary from that of a classmate who was a paralegal which will vary from that of a classmate who was a bartender. I would implore those in an admissions capacity at every level of training to consider these different life and vocational experiences and how they can be utilized to improve patient care. Injecting a little “blue-collar ingenuity” into the tradition-laden profession of medicine might just be what it needs.

  

Author BIO 

Travis Benson, BS is a second year MD student at Harvard Medical School. Travis currently conducts research at the Center for Gender Surgery at Boston Children’s Hospital and the Department of Dermatology at Brigham & Women’s Hospital and serves as the Student Liaison for New England Gender C.A.R.E. Travis’ areas of professional interest include transgender health, dermatology, and bioethics. Travis can be followed on Twitter.

 

 

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Sunday, 31 May 2020