‘Becoming a doctor’ and the life that follows

When she was a third-year medical student at Texas A&M University, Stephanie Swafford wrote about her experiences in medical school in an essay that appeared in the 1996 anthology Becoming Doctors, edited by Parminder Bolina. Now, as a wife, mother and OB-GYN with more than two decades of clinical experience, Stephanie Swafford Bruce, MD, has contributed once again by sharing her experiences in the sequel anthology, Becoming Doctors: 25 Years Later.

“Becoming Doctors”

Becoming Doctors gives diverse perspectives on the joys and challenges of being a medical student. The anthology features poems, stories and illustrations by more than 90 medical students across the United States and gives those outside of the medical field an intimate look into the thoughts and emotions of physicians-in-the-making.

To continue the story of these students, most of whom are now practicing physicians, Parminder Bolina, who is now an internal medicine physician and CEO of Bettehr, compiled the sequel, Becoming Doctors: 25 Years Later, featuring follow-up essays from 25 of the original contributors, including Bruce. These essays describe the many different experiences that can be had after medical school.

In the original anthology, Bruce described two patients that she encountered while on her internal medicine rotation. “Lily” was a stroke patient—the first one that Bruce had treated. Discouraged by treating someone who would never recover, Bruce struggled with whether she was in the correct profession. Later in her internal medicine rotation, however, Bruce treated a stroke patient who would eventually fully recover, and the gratitude of the patient’s family showed Bruce she had chosen the right profession after all.

Becoming a doctor

For as long as she could remember, Bruce knew that she wanted to be a doctor. When she interviewed for medical schools after earning her bachelor’s degree, Texas A&M University’s School of Medicine sparked her interest. At the time, the school offered a program called Leadership in Medicine, in which students were paired with mentors outside of clinical medicine to learn about being leaders. After learning of this program, Bruce knew this is where she wanted to attend medical school. Once admitted, she was paired with Barbara Gastel, MD, a professor at Texas A&M who specializes in biomedical writing and editing.

“I was very excited about that program,” Bruce said. “And very excited about being paired with someone like Dr. Gastel, who not only was a physician, but also had some interests outside of medicine and could help me be more well-rounded.”

Under Gastel’s mentorship, Bruce was able to explore her interest in medical writing during her final year of medical school. She was awarded the British Medical Journal (BMJ) Student Clegg Scholarship, through which medical students spend time at the BMJ to learn about running and writing for a medical journal.

“She was clearly someone who was very bright and thoughtful and had broad interests,” Gastel said. “She had interest in the scientific aspect of medicine, but also a strong interest in literature and more broadly in the humanities. And so, I was very lucky to have her as a student.”

Bruce received her medical degree from Texas A&M University in 1997 and decided to pursue a career in gynecology and obstetrics.

“I love treating women—they make great patients,” Bruce said. “A lot of obstetrics and gynecology is happy, healthy, preventative care. And I enjoy the surgical aspect as well. There’s just really a lot of variety in this specialty.”

Bruce completed her residency through the University of Texas at Memorial Hermann Hospital in the Houston Medical Center. After residency, she went to practice in her hometown at Tomball Regional Medical Center, now the HCA Houston Healthcare Tomball. Having grown up in Tomball, she had worked at the hospital through her Tomball High School Health Occupations course. As a physician practicing at Tomball Regional Medical Center, Bruce became a member of the hospital’s peer review committee, chairman of the Department of Ob/Gyn and Pediatrics and served as the first female chief of staff.

Bruce later moved her practice to Houston Methodist Willowbrook Hospital and became the chair of the Department of Ob/Gyn and Pediatrics, where she was awarded Physician of the Year in 2015.

Interests outside of clinical practice

During her time as chair, Bruce explored different interests and opportunities outside of clinical practice. “I needed a change, just to keep things fresh, and so I could learn more and do more,” she said. “I always felt like I just wanted to make a difference on a larger scale.”

Bruce’s medical practice had always focused on bringing the best care to patients, and she found health care quality to be one of her passions. “In the last 10 years of medicine, quality and quality outcomes data and metrics have become so much more important,” Bruce said. “It’s all about putting patients at the center of care. Quality has to be a huge part of that.”

Following this passion, Bruce graduated from the Master of Applied Science in Patient Safety and Healthcare Quality program at Johns Hopkins University and accepted a position as assistant chief quality officer at Houston Methodist Willowbrook, which she still holds. To her surprise, another new position was waiting for her.

The Texas A&M School of Medicine, which has had a campus at Houston Methodist Hospital since 2014, was expanding their campus to a community hospital. In 2019, Houston Methodist Willowbrook Hospital became a part of Texas A&M’s Houston Regional Campus, with Bruce as the on-site dean of medical students.

“I had no idea that medical students were going to become part of my career, and especially that my college, my own alma mater, would be knocking on our door wanting to bring medical students here,” Bruce said. “But I certainly felt like it was meant to be. That was the school I had chosen so long ago. I was perfectly placed in my hospital and in my position to fulfill that role.” She now splits her time between her gynecology practice, dean of students, and quality work, all of which she finds very fulfilling.

Humanities in medicine

As the dean of medical students and assistant chief quality officer, Bruce has had the opportunity to help mold medical students’ learning. Medical training traditionally had two divisions: approximately two years where students focus largely on basic science, followed by two years where they apply that knowledge to working with patients. Bruce thinks of the two traditional divisions as intertwining cords, and Texas A&M University and other medical schools across the nation are moving to add a new cord: health system science. When all three cords are intertwined together, she said, the result is a stronger rope.

Health system science looks at how physicians work with patients and each other to improve the delivery of health care services. This can include considering a patient’s population when determining treatment, the potential cost of a health care treatment and the teamwork needed within the health care system to provide adequate care to patients.

“It’s not just the doctor, or just the patient, or just the two of you. It really is so much more than that,” Bruce said. “There’s a whole team, and how that team comes together and works to give the best care for each individual patient in each situation.”

To help further include health system science in the medical school, Bruce is developing elective courses for students to take. The topics—including administrative medicine, leadership in medicine and hospital operations—are intended to provide students with ways to explore their interests outside of clinical medicine while giving them tools to become well-rounded, well-equipped doctors.

“I believe that the physicians of today—the great ones, the successful ones, the ones you want to take care of you and your family and the ones I want to take care of my family and me—can’t just be the smartest book people or the best clinicians,” Bruce said. “They really have to understand the whole health system that they’re working in, that they’re in, and that their patients are in.”

Bruce is also involved in incorporating arts and humanities into the hospital itself. She is currently working with the Pearl Fincher Museum of Fine Arts in Houston to help weave art into medicine. To begin building this connection, she worked to bring the museum’s team for the students to interact with at their holiday party. She also hosted a welcome reception for the most recent class of medical students at the art museum during their orientation. Houston Methodist Willowbrook Hospital has already started to incorporate art into the hospital, with commissioned murals hanging on the walls of the main hospital corridor. And recently, the NICU at Houston Methodist Willowbrook received a donation to include music therapy within the NICU for the next five years. This has been so well-received that plans are in progress to expand music therapy further into Women’s Services at the hospital.

Coming full circle

Humanities have been a priority for the School of Medicine since its founding, and it has always been a part of Bruce’s life and career. Her essay submission to the original Becoming Doctors was just the start of a life-long trend of incorporating humanities into medicine, and along the way her career has taken her in directions that she would have never guessed were possibilities.

After 24 years as a physician, Bruce still conveys the same positive outlook on her career choice in Becoming Doctors: 25 Years Later and confirms that she made the right decision for her life. She says her profession has let her participate in the most joyous moments of a person’s life, and she cherishes the opportunities that being a doctor has given her. Her essay describes that the deep relationships formed between a doctor and patient are some that last for decades.

Bruce’s professional life has had highs but also the lows, including being there for people in the worst of circumstances. The devastation of a patient does not escape the doctor, and Bruce is not an exception to this. “It is the counterbalance of the joy that should have been that causes tragedy to cut so deep when things don’t go well,” Bruce wrote in her recent essay. However, the joyous moments of being a doctor and the relationships cultivated with patients are why Bruce has embraced her career choice.

Throughout the past 25 years, Bruce has continued to contribute to the medical field in various ways. From being a medical student at the Texas A&M School of Medicine to now being an established physician and on-site dean of medical students, she has come full circle.