Beginning my journey as an MD/PhD scholar at Yale, I anticipated late nights filled with the memorization of biochemical pathways and understanding drug mechanisms. I foresaw challenging moments in learning to support patients in difficult circumstances. However, what I did not foresee was the extent to which the current federal environment would complicate this path.
I felt this firsthand in early 2025. I came to Yale to investigate the health of LGBTQ+ communities. Yet, when my PhD advisor faced defunding from this administration’s preliminary efforts to reduce financing for LGBTQ+ health research, I needed to change direction. My former advisor could no longer mentor me as a trainee. Concurrently, a diversity supplement grant request I submitted to the NIH has almost entirely been overlooked by the funding body. Funding access for attending conferences, gathering and analyzing data, and engaging in professional development opportunities has disappeared.
Nonetheless, I have discovered something potentially even more significant than the research abilities I would have developed: advocacy is crucial not just for genuinely aiding our patients but also for ensuring our profession remains vibrant. Nonetheless, advocacy training in medical school curricula is frequently perceived as supplementary activities or volunteer opportunities.
The need for equipping physicians with advocacy skills has never been more pressing. Donald Trump’s return to the White House has introduced the greatest danger not only to the foundations of our healthcare systems that serve patients but also to the capacity of the scientific community to generate evidence-based clinical practices. Just nine months into Trump’s second term, federal health research funding has become increasingly unstable. According to one database, Grant Watch, 5,462 grants have been affected in 2025, resulting in a loss of over $2 billion in grant funding. Consequently, the pathway for trainees to transition into early-career physician-scientists, like myself, who depend on these grants for resources and support has been severely weakened.
If medical schools aim to equip trainees for the future we are entering, they cannot remain indifferent. Training upcoming physicians to navigate and challenge the political landscape influencing health is not an issue of partisanship; it’s a matter of practicality. Our advocacy loses its effectiveness without the skills needed to garner support for evidence-based, equity-focused policies and practices. At present, we are facing losses, and adopting advocacy as both a clinical skill and an essential lifeline for our profession and patients is the way forward.
Medical education has begun to take steps toward progress. The LCME, which accredits medical schools in the U.S., has taken a positive step by mandating curricula that focus on health disparities and equity. At Yale, where I participate in the Health Equity Thread of our school curriculum, a new clinical elective specifically dedicated to health advocacy was recently sanctioned for students to learn how legislative processes influence the conditions that cause illness and engage in them. The American Medical Association’s Medical Justice in Advocacy Fellowship offers another illustration of redefining medical practice. Regrettably, these remain exceptions rather than standard practices.
Training institutions need to step up. First, proficiency in health advocacy must be integrated into medical education, and accreditation bodies like the LCME should ensure institutions meet this standard. This could include simulation activities in advocacy, such as composing policy briefs and connecting with legislative bodies. Additionally, establishing pathways or certificates centered on advocacy could provide dedicated opportunities for interested students that would appear on their records and be advantageous for their post-graduation journeys. Third, medical schools ought to allocate protected time and resources for students, which could encompass mentorship programs with physicians currently engaged in this work, links to local community groups or larger organizations like Physicians for Human Rights, and potential curriculum amendments enabling trainees to participate in this work comprehensively (instead of only on weekends or late at night after fulfilling other educational commitments).
As assaults on scientific integrity and health equity intensify, medical education systems face a crucial decision: either permit trainees to be passive technicians within a politicized system or prepare them to be credible advocates for science and justice. Physicians and trainees must acknowledge that any trust they have garnered means very little if they remain silent on political issues that harm our patients and weaken the profession. It is time for medical schools to elevate advocacy to a core clinical competency (not merely an interest or volunteer activity, but a responsibility). The well-being of our democracy, our patients, and our profession hinges on this.
Tyler D. Harvey is a medical student.