The dynamic of the 3 medical students present in The Pitt. Is it an unintentional commentary? I don't know if The Pitt writers care that much about medical school metrics. This is just a ramble.
But, James Ogilvie and Victoria Javadi are there as the 2 faces of stereotypical medical students in contrast to Joy Kwon.
There's the privileged and affluent student with zero bedside manners and a scarcity mindset, which is Ogilvie, and the other is the sheltered affluent student with a good heart but big ego, and a physician parent so they'll benefit from nepotism, which is Javadi. If I had to guess, Ogilvie and Javadi are a part of the top 20% quintile of household incomes nationally, which gives them a significant advantage over someone like Kwon. I'm guessing Ogilvie is affluent because Lucas Iverson mentioned he's privileged, and DGSOM students skewed toward the wealthier end when I matriculated.
Anyone who attended medical school can attest to the fact that a majority of the student population comes from high income households. Statistically, 75% of matriculating medical students come from households that make $120K+ per year, and 25% of that 75% come from households that make $499K+ per year. The unaddressed 25% come from households that make less $80K per year, and they definitely feel it.
20% of medical students have physician parents. That statistic doesn't count extended family, so other forms of nepotism aren't directly factored in. If you want a relevant example, please look at UCLA's Ophthalmology's residency match controversy this year. Nepotism scandals happen every year during matching season in the specialties. Unfortunately, my alma mater and nepotism might as well be synonymous.
Dependent on the year, 20% to 30% of medical students graduate without any educational debt. That is an insane statistic, considering the average medical student educational debt is $250K+.
That's why Ogilvie and Javadi are perfect examples of the majority of medical students who come from a privileged background. I suspect the both of them never had to worry about financial support, which alleviates a lot more worries than you'd believe. There's no need to work to support yourself. There's no need to worry about housing, or food, or transportation. It'd explain why Ogilvie and Javadi seem to be ignorant about the deeper struggles of the common people multiplied by other aspects of America's hellscape, but both of them have different approaches. Ogilvie is indifference and judgment, and Javadi is judgment and an expectation of virtuosity. Both approaches result in them being insensitive or ignorant to the strain others face when they come from underserved backgrounds intersectionality-wise.
Javadi's was more prominent last season, although she was corrected by McKay quickly. Ogilvie's is much more prominent this season, although it's not his first day at PTMC. This doesn't excuse them, by the way. They have too much privilege to simply dismiss out of hand when it comes to treating patients, and they have the resources to correct themselves, but they're realistic character flaw many well-off medical students have. They've been on the high school to medical school pipeline with no life experiences in between.
Javadi is probably worse off because she's 20, a child prodigy, a woman, and seems to have no friends her age. As a woman alone, Javadi is held to a different standard than a man when it comes to compassion, empathy, and maturity. 4th year students in medicine are usually over 25, for reference.
Back to the real matter at hand, Javadi and Ogilvie represent the 2 of the most common faces you see in medical school. Affluent and benefiting from nepotism and affluent cis white man, and now they're fighting for a residency spot.
It's difficult to say who would win, depending on the type of money Ogilvie comes from. If his family money is equal to Javadi's, she'll win that spot easily. Bad news bear: There are extremely well off families who will donate to guarantee a match, and those donations could easily pay the salaries of five attendings or more. Good news bear: Depending on the program, residents and attendings can make sure certain applicants don't get in if they don't like them or if the residents overall prefer another applicant. But, millions of dollars in donations can complicate anything.
Now, Javadi and Ogilvie, in contrast to Joy Kwon. Kwon falls in the 25% of students who come from households that make less than $80K a year. A student with a lower socioeconomic upbringing and zero connections to the medical field beyond personal experience. Kwon is a 3rd year medical student who isn't even their competition, but she's easily a complete contrast to the both of them. Low income students generally have less time to study, less time to shadow, and they don't have as many advantages.
Someone with affluent parents or physician parents can ensure a volunteer role opens up for experience, pay for an extremely expensive course or tutor, or wiggle open a spot on a paper that will pad a resume. If the parents are physicians themselves, they can even add their children to their research papers. The academic publishing complex is rife with nepotism.
Which means lower income students like Kwon and Whitaker have to fight tooth and nail for their place in comparison to the other 75% of their peers. They're not guaranteed a spot, they don't have family money to fall back on, and they're the first one that other affluent or legacy gunner students target because they're the easiest to erase from the board. Low income students are more likely to be humble because they've probably been humbled multiple times, inside the hospital or outside the hospital, especially if they've had to hold down a job to pay bills. They need to ensure the staff at the hospital they're rotating at adores them, and they need to come with pristine knowledge or skills to prove why they're the necessary hire in ways their rich or nepotism benefiting peers don't.
This newest episode provided proof of concept for something that most lower income, less privileged students have over their insulated and privileged peers who have never stepped outside of their bubble. It's the ability to recognize that medicine isn't just academics or a knowledge bank. It's about talking to patients and listening to them so you know how to care for them. It's about the psychosocial relationships within a hospital, between the patient and the patient care team, between all of the hospital staff. If a medical student has ever worked in any customer service industry, that's an advantage because they know how to talk to people while also holding their tongue. It is one of the most helpful skills to develop as a patient-facing doctor and as someone who has to interact with their coworkers constantly. It's much easier to tolerate someone asking questions about something medical and essential to their health when you've honed your patience by listening to someone complain about their ice water being too cold, or biting your tongue when Joshua bitches about the triple shot Americano you made for Matthew tastes different from the caramel frappe he ordered thirty seconds ago.
People think The Pitt is technically a show with no villains*** except for our government that doesn't provide universal health care, American health insurance companies, and the fact hospitals want to pay CEOs $5M - $35M per year, but there are real villains through incoming medical students and some of them are genuinely evil. Like, dose another medical student with laxatives so they can steal their spot and scrub up for a surgery or mess with a classmate's notes on a patient which could jeopardize patient care evil. There's just something about the mix of privilege, unhinged academic environments, and genuine disdain for their peers that creates these overachieving and hyper competitive assholes.
Anyway, Kwon and Whitaker, in contrast to Ogilvie and Javadi, is a very interesting intersection to witness on the show as someone in medicine. Because there's a clear line drawn in how they approach their superiors, peers, and patients due to their class, race, and gender, and what they're allowed to get away with as a result of it. It's very realistic because the divide in privilege and socioeconomic class informs their experiences.
For the Javadi fans, she is definitely a part of the households that make $499K+. Dr. Shamsi's fat salary as a General Surgery attending puts their household in that bracket since they make approximately $585K+. That doesn't include Dr. Javadi's salary as an Endocrinology attending which floats around $300K+. Javadi's character is meant to be incredibly privileged, which is very true to life for many medical students.*
*I am using California metrics when it comes to Javadi's parents' salaries because that's what I know off the top of my head, and PTMC isn't a real place with established salaries.
**I still don't know how Ogilvie managed to get through his clerkship unscathed with his personality and bedside manner unless he's from big money or he's benefiting from nepotism. LA doctors are mean and direct, even if you have a stated disability. Ask me how I know. The only place that I've been where physicians are meaner is NYC, but they're worked like dogs and more skilled because they have less ancillary staff. Either way, I think that boy needs to repeat at least six months of rotations if his bedside continues as is, take two semesters in the social sciences, and volunteer in underserved communities once a week for a year, or stay out of patient facing practices.
***The Pitt does have villains to me. The MAHA mother who wouldn't vaccinate her non-immunocompromised children exists. Just because someone isn't evil down to their core doesn't mean they're not a villain to everyone around them. Being well intentioned rarely matters when the result is terrorizing everyone else and risking public health.
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