Editor’s note: This column is adapted from a commencement address Dr. Underwood will deliver this afternoon at the University of South Carolina School of Medicine’s commencement ceremony.
This time of year, graduating classes from coast to coast will hear advice from all walks of life—musicians and entertainers, corporate executives and entrepreneurs, even a famous YouTube personality or two.
I have been blessed to graduate three times in my life. And if I’m being honest, I don’t remember anything the commencement speakers said. I want this one to be different. I want my message to stay with you because becoming a physician is a journey unlike any else.
So, here are some essential truths that I have learned in life and during my long career in medicine that I hope will help you get through the difficult times that will surely come your way.
It takes a team
No one, and I mean no one, arrives at graduation day on their own. Whether they’re sitting in the stands cheering you on, or their memory is alive in your heart, you’re surrounded by friends and family who love you, who’ve supported you, who believe in you, and they are celebrating all that they knew you would become.
Success is a team sport. The health care world you are stepping into is complex and multilayered and constantly changing. Science and technology and approaches to treatment are never static.
But there is one thing that never changes about medicine: We are at our best when we work as a team in service to our patients.
We all come from different backgrounds and communities. Our professional roles and what we aspire to do may be different. But when it comes to health care—when it comes to caring for people in need—we are all one team. We work in concert with one another.
You may be a doctor or a nurse or a researcher or a technician—we have one goal: Changing lives for the better. And our success in achieving that goal is all that matters.
Did we give our patient the best chance for a positive outcome? Did we counsel her with compassion and respect for human dignity? Did we live up to the high standards of our profession?
Wherever your careers take you from this moment, remember we are united in service to our patients.
Don’t forget what matters
The second piece of advice begins with a story. Your support network is larger than you realize.
When I graduated from medical school, I did not understand the depth of love that my mother, grandmother, aunts and grandfather had for me.
When I was an attending physician, my mother would call every day. And she would always call in the middle of the day when I was extremely busy. Rarely, I would talk to her. Mostly, I would tell her that I would call her back. And most of the time, I didn’t. Instead of relishing in her love for me in those moments, I was annoyed that she was distracting me from a job that demanded my full attention.
It’s painful for me to admit this, but once I achieved my dream of becoming a physician, I forgot about those who sacrificed so much for me to attain that dream. It’s the medical student who takes the tests, who logs all of those hours studying, who may have skipped evenings out with friends or ended a relationship prematurely. You have sacrificed a great deal in pursuit of your dream. But without your family, your friends or your support system, you would not be sharing in this special moment.
And here is where it hits home. One day, that call came that nobody ever wants to receive. It was from my aunt, telling me that my mother was gone.
Now, I wish she would call me. I wish that I could call her back to say, “Thank you for caring, and for keeping me on this path.” It wasn’t easy. I wish I could tell my mom I love her and share in all the great experiences I’ve been fortunate to have.
Be ready to ask for help
Life can be hard. Life will knock you down. But each time, you must get back up. You have to get up.
I was once rocked by an event in my personal life, when I so feared losing family closest to me that I wanted to throw in the towel. I was in so much emotional pain that it felt unbearable. And when you’re in this state, like I was, your mind goes to all kinds of dark places. Even death seemed like it would bring relief.
Instead, I found the courage to ask for help. And I found that help from a very dear friend of mine, someone who helped me work through those heavy emotions and see the world with fresh eyes.
It’s because of him, and also the love and support of my wife, that I made it through that dark moment. They helped me get through the day. And then another day, and then another.
I share this because you’re entering a profession with enormous responsibilities. And with that responsibility comes high stress. Physicians and health care workers are at increased risk for death by suicide compared to people in other professions. Record high numbers experience professional burnout and, I suspect, far greater numbers have days when they regret choosing this professional path.
None of this is easy. The work we do each day to help others can be challenging and painful and filled with emotion. But don’t give up.
Lean on your friends, your coworkers or mental health professionals. Call up a mentor. Call up a family member. Somewhere in your life is someone close to you who can help you get through difficult times.
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The organization that I am proud to help lead, the AMA, has been fighting for years to remove the stigma around mental health and make it easier for physicians to receive the counseling we sometimes need.
As a cornerstone of our Recovery Plan for America’s Physicians, the AMA championed passage of the Dr. Lorna Breen Health Care Provider Act that became law in 2022 and that directs more funding and resources to support the mental health needs of physicians.
We’ve helped a number of states create confidential wellness programs for physicians so they can receive the care they need without jeopardizing their medical licenses. Our efforts, in partnership with others, have led to changes in more than 26 states, 320 hospitals, urgent care centers and other facilities—having a direct, positive impact on hundreds of thousands of physicians.
Seek out possibilities
Life can be mean and nasty—no matter how tough you think you are. You have to keep getting up.
I’ve gotten up more times than I can count. I have more successes than failures, and I have had many failures in my life.
Remember that no one counts your failures except you. Others only count your successes, which brings me to my final piece of advice: Anything in life is possible.
If it’s possible for a kid like me—who grew up in Gary, Indiana, in a single-parent home; a kid whose mother worked 16-hour-days, five days a week—to rise above my circumstances, then all things are possible.
My mom went to work many times without lunch money, but she made sure I always ate.
If it’s possible for a kid who in the sixth grade had a third-grade reading level, to develop a lifelong love for reading, then all things are possible.
If it’s possible for that kid who stuttered in the third grade, who teachers said would be jailed by the time he was 19, who teachers said was incapable learning, to go on to earn not one, but three graduate degrees, become a successful physicians and board chair of the AMA, then all things are possible.
And so my challenge to you is to imagine what’s possible.
Is it possible to create a society where basic human rights are equally protected, without regard to race, gender or sexual orientation? Yes. It’s possible.
Is it possible for you to create a more equitable health that better serves the needs of all people? Yes, it’s possible.
Is it possible to create a society where diverse perspectives are valued and embraced? Yes, it’s possible.
Is it possible for each of you to make a difference in health care? Yes, it’s possible,
Remember those three words—Yes, it’s possible—as you remember your graduation day.
They will change your life.
