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Vital Signs:
Documentary reveals conflicting messages about volunteerism

The setting is Lou's Restaurant in Hanover, N.H. Two DMS faculty members, Drs. George Little and Joseph O'Donnell, are eating breakfast with their daughters, Malaika Little and Katherine "Katie" O'Donnell. The young women have been friends since high school. Malaika Little graduated from Dartmouth in 1997 and then from the University of Vermont Medical School. Katie O'Donnell graduated from Harvard and, in 2003, from Dartmouth Medical School. That breakfast had far-reaching effects.

"We were there to pick our daughters' brains" about medical education, George Little recalls. "We heard something that wasn't quite what we expected."

The young women told their fathers that there was a disconnect between what they expected in medical school and what they found. That disconnect had to do with community service. Med students across the country are encouraged to volunteer. DMS prides itself that 100 percent of its first-year students do. But the daughters questioned whether medical schools take that commitment as seriously as their students do.

Both fathers have a strong commitment to volunteerism themselves. O'Donnell is director of community programs at DMS. Little has been involved with the Peace Corps and international health care. But that morning, says O'Donnell, their daughters told them, "'Dads, we come in with these hearts for service, but, you know, it's hard.'"

"The admissions policies of most U.S. medical schools give the message to people like Malaika and Katie that when you write your letter you'd better talk about your interest in service," says Little. "At Lou's we heard this message, 'Everybody knows on the street that that's what you put in your letters, but then you get to medical school.'" Suddenly, students are under intense pressure academically. There's never enough time to do everything. And there's a subtle message that although community service is important, it mustn't interfere with the real work of medical school.

Need: So "Cecil B. DeLittle" -O'Donnell's nickname for Little in recognition of several films he's produced-and O'Donnell decided to create a film about this mixed message. The result, A Need to Serve, features unscripted students and faculty at both Dartmouth and UVM. At DMS, community service is encouraged; at UVM, it's required. People in the film talk about the rewards of volunteering as well as the conflicting messages. For example, a DMS student notes that students who are struggling academically are advised to let community service go so they can focus on their studies. And yet such activities often help students put classroom learning in perspective. DMS student Gary Maslow says that after volunteering at a camp for children with diabetes, the jargon in class suddenly made sense.

Little and O'Donnell plan to show A Need to Serve at Dartmouth and UVM and possibly at other institutions. A task force has already been created at DMS to address some of the issues it raised. When the film was aired at DHMC's Medical Grand Rounds, it stimulated plenty of discussion. That's just what these filmmakers intended.

Laura Stephenson Carter

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