“Medicine is a journey”: JABSOM 2020 alumna shares reflection upon residency completion

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Dr. Kanoe Quibelan (JABSOM MD 2020). Vina Cristobal photo.

Dr. Kanoe Quibelan is a third-year resident of the University of Hawaiʻi Family Medicine Residency Program. She is a 2016 alumna of the Imi Ho’ola Post-Baccalaureate Program and received her MD from the John A. Burns School of Medicine (JABSOM) in 2020. As Quibelan is preparing to graduate from residency in June 2023, she shares words of wisdom which she draws from her own life experiences, such as establishing work-life boundaries and being true to yourself. Her foundation in faith, family and community is what led Quibelan to her current path in medicine.

What was your life like before medical school?
My life before med school was pretty average. I grew up in a 2-parent household that valued education and instilled in me a deep sense of family, community, and service. I spent majority of my time growing up between my parents’ house in Aiea and with my grandparents in Nanakuli. Based on the two different areas, I was exposed to different life contexts, which looking back today helps me in being empathetic to all walks of life. For education, I went to Kamehameha Schools before moving to California to attend a public High School (and boy, was that different). After high school, I completed a year of college in Southern California and took time off to have my daughter after becoming a single mother. My family was a tremendous help while I tried to figure out how to be a mom and gain some life skills. While trying to support my daughter and figure out how to pursue medicine which was my dream before having her, I experienced being on welfare and learned first-hand how despite the bad rep/stigmatization of such programs it really can help people. While on welfare, I eventually graduated from UH Mānoa, where I double majored in Biology and Women’s Studies.

What led you to your journey in medical school? Was there a particular event or reason that you wanted to go into medicine?
There wasn’t one particular event/reason that steered me into medicine, but rather a series of events that solidified my pursuit of medicine and confirmed that was the path for me. Taken as a whole, sure I can say that there was an illness in my family that I witnessed and impacted me to the point of making me want to know more about medicine and its role in healing people, but primarily it was the small seemingly insignificant interactions that added up over the years that led me to medicine. Working with the homeless, going to church, meeting people “worse off” than me, and at times in my own life needing help to get by. Along my path to medicine, there have been countless “divine interventions” in which I have met people and/or done things that step-by-step have placed me along the road I needed to walk to get where I am today. This has taught me never to discount small opportunities, to always be mindful of who you are and where you’ve come from, and to always be thankful for the things in life that you may have thought were setbacks but were actually set ups for you to be propelled forward when the timing was right.

Why did you choose JABSOM to do your medical training? (You may also mention scholarships that have helped you throughout med school/residency – think we might want to mention those as well)
Honestly, JABSOM was my #1 choice for medical school for various reasons. First and foremost by the time I actually made it to medical school I was a single mother, and that motherly duty always takes precedence. Ideally, raising my daughter in Hawaiʻi with our family and having a connection to her unique culture was important. I lived in California for 5+ years, and there’s just something about being home that you can’t replace. Secondly, I desired to go to JABSOM because I wanted to learn and work with the communities that have raised me to create and deepen connections that would span throughout my career.

It actually took me 2 application cycles to “make it” into medical school, for which I’m actually grateful. Looking back, the first time I probably wasn’t ready to be a med student because I didn’t have enough confidence in my “worthiness” of being in med school despite meeting the basic requirements. The confidence in what I was able to bring to the table in terms of life experiences was more apparent during my second application cycle. I was accepted into the ʻImi Hoʻōla Program, and that experience was a year-long exploration of who I was, what I was capable of, who was in my corner, and it proved to me that I was “worthy of doing medicine” and could handle it despite personal challenges. To be honest, ʻImi Hoʻōla is pretty rigorous, and looking back sometimes I think it was more difficult than certain aspects of residency training. The skills I learned during my time with ʻImi have given me some of the tools I needed to build resiliency and succeed in medical school, residency, and life in general — and for that, I will be forever thankful. Also, I have a solid group of lifelong friends and mentors that are irreplaceable.

Medicine is an educational commitment that we take on in terms of financial burden as we sacrifice the majority of our 20s for a minimum of 8 years of post-high education where we could be working, traveling, building a family, etc. Instead of saving income, investing in stocks, or buying property; future physicians are choosing to defer such major life events because many of us value caring for people and value investing in the health of our communities. I kind of wish I was in the time when there were full-ride medical school scholarships as there are no. However, I’m thankful for the financial assistance I’ve received along my path as it plays a role in decreasing my worry about how I’m going to pay off my loans and be able to live in Hawaiʻi, my home and the place where I want to one day own a home and grow old with my family.

Why did you choose to stay in Hawaiʻi upon graduating from medical school?
I wanted to stay in Hawaiʻi to train post-medical school because I knew that I wanted to practice at home, and eventually on a neighbor island. By staying in Hawaiʻi to train for residency I would be able to become familiar with the various hospital systems and build a professional network of colleagues that would help my future patients.

What were the highlights of your residency? Any challenges? Any life lessons that you learned along the way?
The highlights of residency are definitely the people — my co-residents, my patients, and those I’ve met along the way that have helped shape the physician that I am and who I want to be. There are times when I’ve laughed so hard, cried so hard, been ok, and have not been ok. That’s why medicine is called a journey because it’s an adventure in which sometimes you get lost in the valleys, sometimes you climb the peaks and stand in awe of the hike, and sometimes you just gotta set up camp because you need the rest from the long journey. Medical training as a whole is rough, and residency is not exempt from that. It’s a different type of rough from medical school because you have a little more responsibility and your decisions can directly mean life or death at times.

I could fill an entire book with life lessons I’ve learned along the way, but there are a few that frequently come up:

a) Always seek to be true to yourself because you can’t please everyone, but you can always strive to do what is right even if it’s unpopular.At the end of the day, it’s important to know who you are and not be bogged down with the labels and sometimes unrealistic expectations others will place on you. There will be times in medical training and life where you get lost and you’ll have to remind yourself of who you are, where you came from, and where you’re going.

b) Life was never meant to be done alone. As humans, we need connections to people, to places, to things. During medical training, you’re going to need a good group of friends to study with, to encourage you, and to sometimes drag you across the finish line when you’re too burnt out to do it yourself. In life, you’re going to need people willing to give you an opportunity, to help you when you’re down, and sometimes you’ll even be the one to do the helping. Life is about building and maintaining relationships.

c) It’s okay not to be okay, just ask for help when you need it. You’re not a robot, and you can’t always be at peak performance. There have been times where I haven’t brushed my hair before going to work, where my house is messy, and when I’ve eaten Cheetos for lunch — it’s okay. I’m human, you’re human, and we all have feelings. Sometimes life gets us down, circumstances set us back, and at times we fail–again it’s okay. What’s NOT okay is to normalize having it all together. We all need help at different points of our lives, and as much as possible try to seek help when you need to because you are worth it.

d) Be kind to everyone, even yourself. My mother always told me there is no excuse for rudeness. We really should learn to treat everyone with kindness even when we feel burnt out because we just don’t know what someone else is going through. It’s equally important to learn to be kind to ourselves also. For many of us, we are our own worst critics and can be so kind to others while not being kind to and loving ourselves.

How did you create a work-life balance for yourself – raising a family, making time for loved ones, all while pursuing medicine?
Sad to say that “work-life balance” is a myth–there is no such thing because it’s assuming that it’s an equal give and/or take from either side. Some spend their whole lives/careers finding this elusive “balance”. Both are necessary but in differing amounts and at various times because life is constantly in flux. Over the years, I’ve come to realize that it’s really about focusing on “work-life BOUNDARIES” and in setting and maintaining such you can achieve some semblance of well-being.

Boundaries have to be ACTIVELY SET since there will always be competing priorities: professional, personal, family, etc. Over time you have to decide what are deal-breakers and what you are/are not willing to sacrifice. For example: I need to say no to adding on 2 more patients to my schedule because I need to leave clinic on time to make it to my kids’ birthday party, I need to prioritize sleep even if it means not completing these visit notes because I’m just too exhausted, I need to forego family dinner because I need to study for this important exam, etc. I’m still learning how to do this, especially the maintenance of boundaries. It does get slightly easier over time, but it can be difficult to do at times while still in medical training since your negotiating ability is lower. For me, my duty as a mother will always be a top priority, and I will never apologize for that. There will be times I need to prioritize certain work duties above family time, but I try to do what is in my power to uphold my absolute deal breakers. This may look like leaving work on time to attend a sports game my daughter is playing knowing full well that once I get home I’ll be burning the midnight oil to finish the work or being okay with leaving it until the next day so I can be fully present and enjoy life in the moment. I’ve also gotten better at setting boundaries to prioritize myself and my overall well-being. If I need time off to rest and/or see my own physician I will take the time to do so and not feel guilty about doing it. My hope is that we all learn to get better at taking care of ourselves so we can be good role models to our patients in doing what needs to be done to stay physically, mentally, emotionally, and spiritually healthy.

What are your next steps after residency?
After residency, I plan to be a Family Medicine Hospitalist and practice in Hawaiʻi. If possible at some point in my career I would also like to dabble in a little bit of outpatient medicine as well, time permitting. Eventually, I will likely move to the Big Island and practice there.

What’s the legacy you hope to leave behind as you exit residency, as a Native Hawaiian female physician?
When I leave residency, I hope to leave a legacy in which others will associate me with: (1) the love for my family, people, and for the land that has taken care of me, (2) the fierceness in which I have advocated for myself and for others, and (3) being pono in seeking to operate with integrity and excellence in whatever I choose to devote my time and energy to.

Any words of wisdom you’d like to share with aspiring medical students?
Being a physician is not the ultimate path to medicine. There are other paths with complementary roles because healthcare really is a team effort. Even if you don’t get into medical school it does not mean you will live a less fulfilling life, it just means that you have a different path and that’s okay. Also, age ain’t nothing but a number meaning if you have a dream it’s okay to pursue, it despite thinking you may have missed the age cutoff (I didn’t start medical school until my late 20s). Lastly, take the vacation, try new experiences, and pursue your other passions because work will always be there at the end of the day.

Is there anyone in your life you’d like to thank for helping you along your journey?
There is no way I would be a few months shy of graduating residency and a soon-to-be independently licensed physician without tons of help along the way. Foremost, I have to give thanks to God for getting me here today and for ordering my steps — I really owe everything to Him and then some. Secondly, I’m thankful for my family for all the big and small ways they have carried me and walked with me and how they continue to do so — I love you more than words can express. Third, I’m thankful for my close friends that have helped elevate me, celebrate me, and talk me down when I get too fiery–you know who you are. Lastly, there are numerous individuals and/or programs that have played a significant role in my journey to this point and without your help and support life would be very different today–Teresa Bill/Bridge to Hope, Sandy Leong/First to Work, UHM Native Hawaiian Student Services, Sasha Fernandes/Native Hawaiian Pathways to Medicine Program, ʻImi Hoʻōla Post-Bacalaureate Program, Native Hawaiian Center of Excellence, JABSOM, UH Family Medicine Residency Program, my church ʻohana, and anyone else I may have missed. Mahalo nui loa, and I will continue to pay it forward and sow into the next generation of physicians also!