Graduation Speech

Welcome graduates, family, friends, and mentors, and congratulations to the Harvard MD/PhD class of 2025.
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At my interview for this program, [our program director] asked why I wanted to do an MD/PhD. As one does in an interview, I said true things but not all of the true things. For instance, I didn’t say what I’ll say now, but part of my motivation was something like this:

I wanted to do as much as I could to alleviate illness, and while I didn’t know quite what I’d do with an MD/PhD, I had this sense that by investing in myself—by attaining the knowledge, skills, and credentials that a Harvard MD/PhD affords—I would be able to convert my passion into impact.

As a young person, it’s natural and often correct to think this way; we learn from a young age to think of investments in ourselves as proxies for impact. If a passionate high schooler asked me how to make the world a better place, I’d advise them to go to a great college and learn as much as they can. Focus on changing the world later. 

By the time I was applying to MD/PhD programs, I’d gotten into the habit of deciding what professional opportunities to pursue by thinking primarily about the professional benefits those opportunities would confer to me. For instance, when deciding which of two research jobs to accept one summer, I thought mainly about what I would learn, which experience I’d enjoy more, and how each would enhance my MD/PhD applications. I didn’t decide based on the relative importance of the research each lab was conducting.

I don’t think this was unreasonable at the time: as students, it’s often made sense to focus on accruing what we might think of as professional potential energy, with the goal of eventually converting this to impact—or kinetic energy—down the line. 

I worry, though, that now that we’ve gotten used to and become really good at investing in ourselves, it’s easy to reflexively do this, and to lose sight of the fact that optimizing our professional potential is not the ultimate goal. It doesn’t help that medical and academic institutions often incentivize investing endlessly in ourselves. For instance, doctors who train longer can generally expect to be paid more, regardless of the value their practice ultimately provides to patients. In academia, too, measures of success often aren’t well correlated with impact. As just one example, a researcher in my PhD department who developed a therapy that has saved tens of millions of lives never received tenure.

At the point I was choosing between those two research jobs, I probably wouldn’t have been able to figure out what research project was more important, which made it easy not to factor impact into my calculus. But importantly, being unsure which of two things matters more is not the same as them mattering equally. 

This is one of the ways in which our MD/PhD training has transformed us: today, we can recognize the difference between research that might yield a flashy publication, but will not, ultimately, matter that much, and research that has the potential to transform patients’ lives. As we gain even more knowledge and experience, our ability to assess the potential impact of different projects—not for us, but for the world—will grow. We should strive to further cultivate this insight, and we should treat it as our North Star.

I must admit that I’ve been waiting seven years to soapbox about this, because my research focuses on how to ethically allocate health resources, and especially research resources. Usually, I give talks to rooms full of philosophers, so it’s exciting to share these thoughts with people who might actually be able to act on them.

So I want to share three things. First, over the past century, the health research enterprise has done more than perhaps anything to extend human life and promote economic prosperity; our work can be vitally important. Second, the benefits of health research are unevenly distributed across patient populations; even after accounting for how many people have a disease and how severe it is, some diseases receive vastly more funding than others, and this predictably affects which patients reap the benefits of health research. Third, some researchers make much more transformative discoveries than others, and while much of this is due to luck, some of it is due to choices researchers make about whether to optimize their potential or their impact. 

All of this to say: there is much we cannot control about how research resources are used—especially now—but we can choose what causes and conditions we devote our lives to. In making these choices, we should prioritize areas of research that have been neglected by the research enterprise, and should strive to pick projects that have the potential to transform our understanding of those diseases and, ultimately, patients’ lives. 

In two days, we will transition from being students to being practitioners. And I would argue that this transition also marks the point at which we should focus increasingly on converting our professional potential into impact. We are already among the most educated 0.01% of Americans, and we have benefitted from millions of dollars of public and private investments in our educations. Above all, though, you are some of the most brilliant, dedicated, and passionate people I have ever met; if anyone is capable of changing the world—not in small ways, but in big ways—it is us. 

Our societies have invested heavily in us because they believe—rightly—that we are capable of unlocking the solutions to the most pressing health problems of our time. We carry the dreams of the taxpayers who have sacrificed so we can study here, the politicians and protesters who defend the importance of our work in congress and in the streets, the patients who enroll in our trials in the hopes of seeing tomorrow, the millions of children who share every bit of our potential but who will never have a shot at a fraction of our educations, the billions of people worldwide for whom treatable illnesses remain death sentences, and the future generations we might spare from a hundred maladies. We owe it to them to do as much as we can to promote human health, even when doing so requires taking a riskier, less prestigious, or less well compensated path. 
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I have no doubt that we will show both the naysayers and the large majority of people who believe in the value of our work that we are worthy of their trust, and their faith, and their hope. Congratulations again, class of 2025. I couldn’t be prouder to have studied alongside you, and I can’t wait to watch you build the brightest possible future.