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Medical students in the University of Pittsburgh School of Medicine's incoming class recited two oaths via Zoom this year -- the Hippocratic Oath, and an to address what they see as the most pressing challenges in medicine today.

"As the entering class of 2020, we start our medical journey amidst the COVID-19 pandemic and a national civil rights movement reinvigorated by the killings of Breonna Taylor, George Floyd and Ahmaud Arbery. We honor the 700,000+ lives lost to COVID-19, despite the sacrifices of health care workers," the updated oath begins.

"We recognize the fundamental failings of our health care and political systems in serving vulnerable communities. This oath is the first step in our enduring commitment to repairing the injustices against those historically ignored and abused in medicine: Black patients, Indigenous patients, Patients of Color and all marginalized populations who have received substandard care as a result of their identity and limited resources."

What follows are pledges to support all patients, their colleagues, and the next generation of doctors, and to not neglect self-care in order to do their best work.

"Every word in that oath was chosen with purpose. We wanted to make sure there were no questions about the values we were trying to convey," said Ashley Whited, an incoming student who was on the oath-writing committee.

"It reminds us of why we're here, and what we expect from ourselves as we become physicians," said student Nerone Douglas, who was also part of the oath-writing committee.

"Instead of the all-encompassing 'Do No Harm,' we specifically address what our community needs when it comes to a physician," Douglas added. "They need more than science and know-how. They need someone who incorporates them as part of decision-making, so they can take care of themselves as well."

Whited noted that one of the biggest challenges in writing the oath was to make sure that it represented every voice in their nearly 150-student incoming class. All students had input and the 9-member oath-writing committee took every opinion into account in the final draft.

The diverse backgrounds of the class informed the oath, with Whited acknowledging that her own health struggles informed her perspective. When she was younger, she had unexplained seizures that went undiagnosed and untreated for a long time.

"They weren't showing up on normal EEGs," she said. "It was hard sometimes to get physicians to listen to my story and experience, instead of looking at a chart and numbers."

She finally found a physician who "used intuition and narrative medicine" to arrive at a diagnosis and provide proper treatment.

Douglas said his experience similarly informed his desire to draw up a new oath. He was born in St. Lucia and immigrated to Ossining, New York, a town north of New York City on the Hudson River, when he was about 10 years old.

"Growing up in the Caribbean, I saw in small villages how big of an impact a physician can have on a community," he said.

Douglas said when he worked on projects in the Bronx, he was surprised to see the lack of access to healthcare in a first-world country. "The healthcare gap is so much bigger" than it was in St. Lucia, he said, with "people not being able to get the care they needed."

The oath is particularly aimed at addressing healthcare disparities for all groups, and promotes patients being involved in their care.

Douglas led the recitation of the new oath over Zoom, and students' families were invited to watch. The university even printed up cards for the back of students' name badges so that they could carry the oath around with them as they practice in the hospital.

Whited said oath-writing will become a tradition, with each new medical school class being invited to write its own unique oath during orientation week, to help them establish their professional identities as physicians.

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