A foundational experience that opened the door to medicine was working at my family's optical practice. My mother is an optometrist, and our practice was the first in the small town's history. When I was young, my jobs included sweeping floors and cleaning glasses. Over time, I filled numerous positions, including receptionist, optical technician, and sales associate. I saw how my mom juggled being a working mother, business owner, and medical representative of our small community, which instilled in me the work ethic I have today. I learned that many of the patients had never been to an optometrist or been fitted for glasses due to the lack of providers in the area, opening my eyes to the deficiencies in care in rural areas. My favorite part of this experience was forming relationships with the patients by listening to their stories. I firmly believe that everyone has something to learn from and something to teach to everyone they meet. Primary care excites me the most, specifically family medicine. The diversity of patients ranges from newborns to adults, and in one day, I can see a grandparent, parent, and child in the same exam room. I enjoy talking face-to-face with patients, understanding their concerns, and establishing a strong connection to become a trusted advisor. I attend the Quillen College of Medicine and am on the Rural Primary Care Track. A small cohort of students and I are preparing to become primary care doctors and practice in rural or underserved areas of the country. One of the core didactic learning priorities of the program is about combatting health disparities and inequities in our patient population, and we precept in clinical settings to gain experience working with disadvantaged communities. 20% of the United States population lives in rural areas, but only about 10% of doctors serve this population. This healthcare provider deficiency is one of many barriers that rural Americans face when it comes to healthcare. After completing medical school and residency, I will practice as a rural family doctor in Tennessee. I will provide care to a population in need and ensure that the people in my community can attain their highest level of health. Health equity matters because no one should receive inadequate healthcare simply because of their geographic location. Some issues that I am passionate about and will address in my future practice include accessibility to care regarding mental health services, specialty care consultations, and access to preventative women's health services. Transportation and a lack of stable home internet in rural areas hinder visits for specialty care and mental health care. The small hospital in Mountain City, Tennessee, has a center with computers and internet access so patients can have virtual visits with specialty care providers. I want to establish a center such as this one for my patients. I discovered a passion for teaching while in college, and I would love to teach students about the social determinants of health and the importance of rural primary care. The most challenging aspect of medical school has been staying motivated, as I spend well over 80 hours per week between class and studying. However, I have greatly enjoyed precepting in rural clinics and hospitals. Applying my knowledge to patient care settings is rewarding and undeniably motivating. My future patients and students hold me accountable and inspire me to learn as much as possible. I am honored to have the opportunity to study medicine in such an incredible program. I will use my desire to care for patients to overcome one of the most rewarding challenges, the journey to become a physician.

Dementia-related illnesses, including Alzheimer's disease, strain the families of those affected. This strain can be emotional, physical, or financial. If the family member is being cared for at home, it is time-consuming, scary, and physically taxing. If the family member is being cared for in a skilled nursing facility, the financial aspect can be overwhelming. I have worked as a nursing assistant in a nursing home on a dementia unit and seen how the mental and behavioral changes of our residents affected their loved ones. However, I did not fully understand the toll that Alzheimer's disease could have on the family until I experienced a new perspective. Both of my grandmothers have Alzheimer's disease, and the toll on my family is evident. My paternal grandmother lives with my immediate family in Tennessee. She is frequently at home alone during the day while my parents work and my younger sister is at school. Last year, while home alone, she had an unfortunate misstep while trying to find a light switch and fell down a flight of stairs. As a result, she had a broken neck and had to be in an upper body immobilizing brace for three months. This physical impairment put a significant physical strain on my parents because they had to do everything for her, from feeding her at mealtimes to helping her use the bathroom. My parents cannot afford to put her in a nursing home and cannot take care of her full-time. They also missed work while she was recovering from her accident. This difficult position has made life at home very stressful.  My maternal grandmother lives with my grandfather at their home in Maryland. She sleeps in a hospital bed in a spare bedroom and has been getting progressively worse over the last year. She is incontinent and slowly losing her ability to move. They have no family nearby, and my grandfather is scared to leave her at home alone for any length of time, even when grocery shopping. Caring for her has been physically demanding on my 92-year-old grandpa. This experience has been emotionally straining for him. He is absolutely distraught with worry that he will lose her or that something will happen to him and he will be unable to care for her. Neither my grandfather nor my parents can financially afford to put either grandmother in a care facility. This financial strain is something I did not understand or experience while working at the nursing home. I saw the physical and mental effects on my patients as a result of the disease and observed how stressed their families were when they came to visit. Now that I have seen both the family's and the caretaker's side of this disease, I have learned to be observant of the family's perspective when treating a patient. As healthcare workers, we need to be conscious not only of our patients but of the families of our patients.

Ten years from now, I envision myself as a family physician practicing in a rural, underserved community. The people I hope to provide medical care for are those in desperate need of primary healthcare services. Many rural towns have only one doctor to serve them, meaning there is a drastic deficit in care for this demographic group. Personally, I know of many people my age who have never been to a primary care physician. This is a public health crisis. As a physician, I will be working constantly to fix two issues within healthcare, limited access to primary care and poor communication between professionals and their patients. Preventative medical care is crucial, with services ranging from regular screenings and immunizations to check-ups and counseling services for increasing awareness of health risks. These services significantly reduce the likelihood of future illness and increase the rates of early detection, both of which save lives. According to Healthsystemtracker.org, preventative care made up a mere 2.9% of total healthcare spending in the United States in 2018. Primary care is not being treated as seriously as it should be. Many areas in the United States are underserved in primary care. Unfortunately, many doctors do not have the desire to go to these areas to practice. However, I feel that this job would be more fulfilling for me than any other. I will have the opportunity to help those in need directly, and on a massive scale. In addition to the difficulties of gaining access to primary care in rural areas, there is also a great divide in healthcare caused by weak doctor-patient relationships. This is likely the result of poor effort from physicians to convey crucial information properly to their patients, and a resulting lack of trust by patients of their medical advisors. As a doctor, I will establish strong relationships with my patients and ensure they have all their questions answered before moving forward with a procedure or to more specialized care. Trust is extremely important in my personal life, so it is assuredly a quality I will implement as a physician. My goal is to ensure that my patients have confidence in me that I will give them the best medical advice from the resources I have available. If I do not know the answer to a question they pose, I will pledge my best effort to answering it and to solve any problem that may arise within their care plan. Patients are also more willing to convey information about their personal lives or daily routines to a medical professional that they know personally and can trust. This information that is often withheld could potentially help save their life. Examples of these pieces of information are recreational drug use, daily vitamin intake, non-prescribed medications, and their complete medical histories. Another potential inhibiting factor to appropriate care is the ability to read, a shameful thing to have to admit to someone they do not trust, or to someone who has achieved a much higher level of education. These factors could inhibit proper medical care and are crucial to be conveyed in the healthcare setting. I grew up in a rural town where there were no primary care providers. Preventing disease as early and as widespread as possible, establishing clear and concise communication between myself and my patients, and ensuring that I am understood and trusted in my patients’ eyes are my goals as a doctor. I will be a rural family physician that will first make a difference in my community, and that in turn will help the world.