Abstract
In this case, a student with chronic health issues struggles with imposter phenomenon in the context of her goals to become a doctor. She has transitioned well and holds sophomore standing even though she is a first-year student. She meets with her academic advisor seeking guidance.
Keywords: dual credit, medical conditions, imposter phenomenon
Primary Characters
Casey Thomas (she, her, hers) is a white female from a middle-class background in her first year at a four-year institution. She is majoring in public health and is taking pre-medicine courses.
Ben Fields (he, him, his) is a multiracial male academic advisor in the Department of Public Health and Health Sciences. He has been advising for three years, and his degrees are in health sciences.
Context and Case:
Casey is a 19-year-old white female who graduated from her high school with a 4.0 GPA. Due to her dual credits from high school and AP scores, she completed all but one of her general education courses before she started college. In this first semester, she seems to be a strong student as she currently has As in all her classes, including chemistry, statistics, public speaking, and a 300-level public health class.
Casey’s transition to school has gone well so far. She lives on campus with three suite mates and is enjoying getting to know them. Casey has also gotten involved in campus activities such as playing trumpet in the university band. Additionally, she volunteers at a local animal shelter every week.
After some confusion with the academic advising center due to her major change from medical biology to public health, Casey has scheduled an appointment to see her advisor, Ben, to discuss her spring class selections and her career plans. This will be the first time they have met in person; however, they did communicate via email recently.
At Casey’s appointment, Ben notices that she is nervous but confident. She has a good idea of what classes she needs to take for her major and seems to be enjoying her public health class, even though she says she is the youngest student in the class. Casey has clearly articulated her interest in the major.
After a while, the conversation turns to what Casey would like to do with her public health major. She talks about shadowing doctors and physician assistants over the past year in her hometown. She has also volunteered in a hospital and earned her certified nursing assistant certification to enable her to work when she goes home in the summer. She feels that she could be a good doctor and is very interested in medicine.
During the conversation Casey shows signs of anxiety and tension when she talks about the process of becoming a doctor. Ben asks her some follow up and clarification questions to see if he can better understand what is causing her stress. Finally, Casey reveals that she has several chronic medical conditions that cause her constant pain primarily in her neck and head. Since she has moved so far from home, her medical referrals have been difficult to transfer and she is struggling to find adequate health care support near school, so her medical care has been nonexistent. Some days she is in tolerable pain, some days she is in agony. She hopes that one of her specialists at home will figure out a way to reduce her pain, but that has not happened so far. As Ben listens to Casey, he wonders how she is managing to do well in her classes, as well as perform in the band, and function on a day-to-day basis.
Casey tells Ben that she has struggled with depression and anxiety but feels that she is doing mostly fine now and is taking her meds. She also reveals that she is a perfectionist and has never received any grade lower than an A. She is afraid to get anything less. She acknowledges that she needs to be realistic but does not seem to accept that she can be less than perfect. She admits that she also struggles with the imposter phenomenon. Above all, Casey reveals doubts that she can or should have medical school as her goal because of her health issues and her lack of confidence overall. However, she has dreamed about becoming a doctor for as long as she can remember – even before her health conditions became such an issue.
Casey’s degree plan currently includes her public health major plus all the pre-med prerequisites that she would need to apply for medical school. According to Ben’s calculations, Casey will graduate in three and a half years if she stays on the pre-med track. However, she could graduate in two years if she just does her public health major coursework.
Ben realizes that on the surface, Casey seems capable of excelling at the university and likely would be competitive to be accepted into medical school. However, when factoring in all the chronic medical conditions she has, Ben is concerned that she is setting herself up for a hard, painful journey that may not be feasible. He wonders if she has considered other options such as going to graduate school for public health. Ben knows that he must carefully approach Casey due to the emotions related to her life-long dream of being a doctor and the reality of her health conditions. At 19-years-old, Casey faces a big decision: continue the pre-med track, spend additional semesters (and tuition money) but potentially find she is physically unable to handle medical school or change directions and plan for a less grueling, though perhaps less rewarding, graduate degree and career in public health.
Discussion Questions:
- Which career and student development theories should Ben consider in working with Casey?
- How might Ben approach the conversation with Casey about her option to graduate early with a public health major? What are the pros and cons of doing this while she continues to pursue pre-med courses?
- Given the intensity of pre-med classes, how can Ben help Casey navigate the anxiety of her program but also the anxiety related to her health and other life issues?
- What campus or community partners could Ben suggest or help Casey connect with as she mulls her medical school versus graduate school decision?
Author Bio
April Reibestein (she, her, hers) is pursuing a master’s degree in academic advising at Kansas State University. She has worked in international student programming, secondary education, and academic advising. Currently, she lives with her military family in Washington state.