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Janet A. Jokela, an infectious disease physician, discusses her article, “Match Day 2025: Protecting our students’ futures.” She explores the unprecedented challenges facing medical students, including a U.S. measles outbreak, censorship at the CDC, disrupted research grants, and threats to biomedical research and public health infrastructure. Janet emphasizes physicians’ responsibility to support graduating students and their future patients, highlighting actions by medical journal editors, professional societies like the American College of Physicians, and colleagues advocating for science and health care. Listeners will discover practical ways to contribute, such as engaging in pro-science advocacy and supporting international medical graduates vital to the U.S. health care system.
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Transcript
Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today, we welcome back Janet A. Jokela, infectious disease physician and treasurer of the American College of Physicians. Today’s KevinMD article is “Match Day 2025, protecting our students’ futures.” Janet, welcome back to the show.
Janet A. Jokela: Thanks so much, Kevin. Delighted to be here. All right. So this article is going to go out on Match Day 2025. So tell us what you wrote about. Yeah. You know, it’s March, which means that it’s Match Day for our graduating students. That’s an incredibly exciting and important day for them and for all of us who’ve been working with students. The students will learn where they’ve matched for residency and where they’re going to be for the next three-plus years, at least. It’s a really exciting time, a really important time. This time in 2025, again, given all the things going on in society right now, this feels a little different to me. Not Match Day so much for itself, but the broader things in society that are going on right now. And it made me think, what’s our responsibility to help protect our students’ futures and their future patients? So that’s kind of where I landed with this article.
Kevin Pho: All right, and Match Day, of course, is a seminal event in any physician’s career. It’s a… it’s a day that every physician is going to remember. So when you talk about the potential threats specifically with 2025, go into more detail. What are we talking about?
Janet A. Jokela: Yeah. Yeah. Great question. I tell you, the song that has been stuck in my head has been from the musical Hamilton, which I love. OK, loved. But the song “The world turned upside down,” and I’m thinking, you know, all right, well, why is that in my head? Well, in many ways, it feels like the world that we know has been turned upside down, with the censorship at the CDC, the threats to funding at the NIH, and kind of on and on. There’s a measles outbreak, a big measles outbreak, and just lots of things going on right now that kind of threaten and feel destabilizing to whether it’s ourselves or colleagues, and there’s a lot of work that’s being done on biomedical research, public health, and all of that. And it just—those are the things that concern me, but it also concerns me for our graduating students and their future patients.
Kevin Pho: Now, for this new cohort of physicians who will be matching today, what are some immediate threats that they may have to face regarding, you know, you mentioned things with cuts in public health, cuts in the NIH, you know, now with the spread of things like measles. What do they have to look out for going forward after leaving medical school?
Janet A. Jokela: Yeah, and here’s the thing, you know, they may not feel or see the immediate results of these actions that are taking place right now or the immediate threats, and things may kind of go on as it seems like they have been going on. But for those of us—and I guess I can say this, all right—but for those of us who’ve been around for a little while, we can see what this means. And in many ways, the article in the Annals that was recently published called “Damage control,” penned by Christine Lane, the editor of Annals, and her team about the really in-the-weeds kinds of things that they’re seeing impacting publishing scientific papers—you know, that’s a good example of what’s going on. People are having to remove their names as authors or, you know, the Annals team is trying to contact authors and they can’t reach them because their emails no longer exist. I mean, just basic things that will have long-term ripple effects that again, our students may not see right now, but down the road, the impacts are potentially profound. And that’s the worry. And…
Kevin Pho: You mentioned things like the censorship. Talk about what’s happening with the CDC specifically and how that’s going to affect this new cohort of physicians.
Janet A. Jokela: Yeah. It’s a great question, Kevin. And I tell you, with all the things happening, it’s like we may describe what’s happening today, but tomorrow it may be very different. You know, recently we heard that all these people who had been laid off—the probationary employees—have been ordered by a judge that, you know, that shouldn’t have happened, and all these people should return to work. So exactly how that’s going to play out, of course, nobody knows. And we don’t know if these people who have been laid off will be seeking new employment somewhere else or if they’ve already identified new employment, but it’s really threatening the integrity of the workforce, and the public health, and the scientific integrity of the workforce. So for instance, at the CDC website, there was a little disclaimer posted there saying, you know, all this information here has all been vetted, if you will, by the federal government. And these are things which we can say now, and other things we can’t. I mean, the very basic kind of, in some ways, threatening the very basic communication that the CDC has with all of us as physicians and everybody else in the world. And it’s just chilling. It’s chilling.
Kevin Pho: Now, you work, of course, in an academic medical center, and a lot of these newly matched physicians will be rotating likely through academic medical centers. I’m not in an academic medical center, so tell me what you’re seeing in terms of how some of these potential political changes may affect the training of these newly graduated medical students.
Janet A. Jokela: Yeah, yeah, yeah. That’s an important question. You know, one of the things that we haven’t talked a lot about—or at least this is an important piece of the equation, I think—is international medical graduates. So, just like the U.S. graduates graduating from medical school, international medical graduates also find out, on March 21, where they match into residency. And there’s a sizable proportion of international medical graduates, for instance, who fill internal medicine intern slots in residency programs across the country. So it’s a big proportion, almost close to, not quite, but almost close to 50 percent.
So given that, many of these international medical graduates come on J-1 or H-1B visas or maybe green cards. So when things happen in the U.S. and there’s, you know, an individual on a green card who has been detained, it sends a chill throughout the whole community, and people are frightened. So whether it’s residents, early-career physicians, people are just quite unsettled, like, what does this mean, and where is this going, and what does it mean for the future? So our current U.S. medical student graduates may be going into specialties and programs where they’ll have colleagues who are international medical graduates who are facing these threats, and it just creates a lot of uncertainty and, unfortunately, a lot of fear. And that’s just sad. And, you know, in addition, I think anytime that we’re kind of preoccupied or worried about other things that may be going on, it takes away our concentration from taking care of the patient in front of us. And that’s problematic too. So those are all concerns, all issues.
Kevin Pho: So, is there anything that these students can do to prepare themselves going forward? I know you said there’s a lot of uncertainty, and I’m sure that a lot of us didn’t anticipate the current situation. Is there anything that our students can do to prepare for these uncertainties as they go into residency?
Janet A. Jokela: Yes, I think there is. One, unfortunately—but it’s important, and I’ll say this especially as an infectious disease physician—get familiar with measles. You know, the vaccination rates vary a little bit around the country, and there are pockets where people are less vaccinated than elsewhere. And so it’s really important for graduating students, residents, and all of us to be familiar with how measles presents, what the symptoms are, what the rash looks like, the time course, and also how to deal with it. Vaccination is the best way to prevent measles, and that’s critical. So that’s, you know, that’s one small thing, but measles is a really important thing to be familiar with and know how to deal with when a patient comes walking in the door potentially with that. The rest of it, I think, is certainly for internal medicine residents and physicians to stay connected with the ACP. There’s a really nice link on the ACP’s site about the latest advocacy news, the latest advocacy efforts. It lists all the different activities ACP has taken recently to try to combat and address these concerns, and it offers a way for students and residents to get involved and support the various efforts that are going on to try to address all this stuff.
Kevin Pho: Now, in terms of, of course, advocacy: So these newly matched physicians, of course, getting involved with the ACP, but what are some other ways that they can advocate and perhaps push back about some of the uncertainty and policies that they may not agree with?
Janet A. Jokela: Yeah. That’s a really important question, I think not only for our graduating students, but for all of us. I think the primary issue is just to be as prepared as possible. We never know when an opportunity will present itself, whether it’s talking to a patient or talking to our fellow colleagues or nurses and other staff around the hospital, or, you know, at church or elsewhere in our community—wherever we might be—to answer questions about what’s going on and what we think is most important and kind of how we think it may be best to navigate this. So with that, to be as prepared as possible and to be up to speed on what’s going on, I think, is really important. We’ll each have different ways to respond and to react to what’s going on and how to navigate forward, but I think, at minimum, as long as we know what’s going on and what may be the next best thing to do to help protect our patients and our students’ future careers, we’ll be better prepared to respond to questions and communicate with the public or our patients or whoever it might be in whatever setting we may find ourselves.
Kevin Pho: Now, are you seeing some of this nervousness and uncertainty among the fourth-year medical students and residents? So tell us what you’re seeing on the ground.
Janet A. Jokela: Yeah, a lot of it is also together with colleagues. I think colleagues, especially people who may have a little bit more perspective, if you will, on this, you know, they’re especially feeling this and especially recognize, in some ways, the seriousness of the situation. Among the students and the residents, they’re savvy—I mean, they know what’s going on too—and they may question, well, how do we respond? How do we deal with this? And some may be more inclined to be calling congressional representatives and those offices regularly; others may be marching. There was just recently this march on science, which took place. So there were a number of colleagues who were marching on science, not only here in Champaign-Urbana, but also across the country, just to bring attention to the gravity, really, of these concerns and these attacks on science and on biomedical research.
Kevin Pho: We’re talking to Janet Jokula. She is an infectious disease physician and treasurer of the American College of Physicians. Today’s KevinMD article is “Match Day 2025, protecting our students’ futures.” Janet, let’s end with some take-home messages that you want to leave with the KevinMD audience.
Janet A. Jokela: Thank you so much, Kevin. First, absolutely, let’s celebrate Match Day. It’s a fantastic day, and we’re so excited and proud of our students, and we’re proud of everything that they’re going to be doing. The second is, let’s be prepared. Let’s be prepared to address any questions and things that may come up, and that’s our responsibility to do that. So again, in these uncertain times, we want to be prepared and be the experts to answer questions and address issues that come up as they present themselves to us.
Kevin Pho: Janet, as always, thank you so much for sharing your perspective and insight, and thanks for coming back on the show.
Janet A. Jokela: Thank you so much.
