May 26, 2010 — The University of Virginia's Post-Baccalaureate/Pre-Medical Program packs into two semesters all of the prerequisite courses for medical school that would normally be spread over three years of pre-med undergraduate studies.
Intended for "career changers" seeking a fast track to medical school, it's an intense schedule, said the program's director, Beth Bailey.
Rebecca Donald maintained her characteristic even temper and quiet self-confidence throughout the program, said Bailey, who linked Donald's success to her unique background as a former hospital chaplain.
The wisdom and personal growth Donald gained from dealing daily with trauma, dying and grief made her an outstanding student in the program, offered by U.Va.'s School of Continuing and Professional Studies – and promises to make Donald an outstanding doctor, Bailey predicted.
After earning her bachelor's degree in biology from Davidson College in 2003, Donald managed a behavioral neuroscience lab there that did Alzheimer's disease research.
Though she enjoyed science, and felt drawn to follow the medical footsteps of her parents (her father is a doctor and her mother is a nurse), she was leery of the years of training required to become a doctor. Instead, she opted to build on her strong Christian faith by earning a master of divinity degree from Duke University.
Her extensive record of volunteering at Davidson – including with a local women's shelter, a bone marrow donor program and a counseling service for survivors of sexual abuse – was recognized with a Distinguished Service Scholarship to Duke Divinity School that paid for three-quarters of her tuition, and a Rotary Ambassadorial Scholarship-funded year of study in France between her undergraduate and divinity studies.
Her service continued at Duke, where she led a program to promote engagement and service in the local community, and later at U.Va., where she volunteered at the Charlottesville Free Clinic.
At Duke, she worked one summer as a chaplain intern at the University of North Carolina hospital and "loved it," setting her on a path of hospital chaplaincy and awakening a love of medicine that she'd "been trying to push down for a while."
After graduating magna cum laude from Duke in spring 2008, she worked as a chaplain resident at Virginia Commonwealth University Medical Center in Richmond, ministering to patients, families and staff while earning a master's degree in patient counseling.
Her supervisor, Angie Flack, assistant professor of patient counseling and coordinator of the clinical pastoral education program, said Donald was exceptional resident and a strong advocate for patients and families, especially those who were intimidated or had trouble speaking for themselves.
A major part of chaplaincy training, Donald said, is working through one's personal theology and emotional responses to the pain, sorrow and grief of others – which Flack said is crucial to developing the capacity to be present, sensitive, respectful and empathetic to patients' wide range of emotions, spiritual beliefs and life histories. When done well, the chaplain helps patients tap into the support of their faith backgrounds. Donald mastered that challenge, Flack said.
During her chaplaincy, Donald developed a particular passion for working with one type of patient. "It is such a privilege to be with people at the end of their lives," she said. "It's really satisfying to me to help people die well" — something she said is "complicated, because it's so emotional."
It generally involves helping them accept what is happening, walk through the traumatic times and express their emotions, while helping families be together, make end-of-life decisions, and, sometimes, reconcile with estranged loved ones.
Facing death often strains faith and spurs a patient and family members to question why they are suffering, Donald said.
"As a chaplain, a lot of my job was giving people the space and the freedom to say those things, like, 'God, I'm angry at you.' 'God, I can't believe in you right now.' 'You betrayed me.' Giving voice to those emotions is really powerful," she said.
"I don't think it's my place to try and explain God, but it is my place to help people wrestle with their own experiences of God."
Donald plans to remain open to all facets of medicine, but said she feels drawn to working in geriatric medicine and palliative care. Both are "great ways to integrate a passion for medicine and ministry," she said.
With her pre-med classes behind her, Donald plans to apply to medical schools, including U.Va., for enrollment beginning in fall 2011. Until then, she plans to work as a medical scribe in U.Va.'s Emergency Medicine Department.
Once in medical school, Donald's challenge will be to harness her empathy and emotional intelligence to complement the medical judgment she will learn, VCU's Flack said. She will need to maintain an awareness of her role as physician versus chaplain, and may need to establish firm boundaries between the two.
Donald said she won't limit herself to "a practice of medicine that doesn't engage some sort of caring for the emotional well-being of my patients."
Like the ministry of hospital chaplaincy, a more holistic approach to medicine benefits from building relationships with people, she said.
It is easy to focus on caring solely for physical needs – taking blood pressure, ordering labs or prescribing a cholesterol-fighting pill, she said. But it's a privilege to get to know a patient and figure out all the other things about them that contribute to their health, like family histories, work background and home environment.
Bailey expects that Donald will build relationships with her patients and provide the type of holistic care that patients have long sought. Her combination of academic brilliance and humanistic care, refined during her hospital chaplaincy service, is rare in someone her age, Bailey said. "We feel confident that she will be a superb medical student, and ultimately, the kind of physician we all hope to have care for us and our loved ones."