DURHAM, N.C. – The demanding schedule that is experienced by student-athletes at Duke can only be rivaled by a few academic pursuits on campus. These studies are often regarded among the best in the country academically, and are designed to yield careers for only the most dedicated, driven and well-disciplined students by the end of their undergraduate enrollment.
Near the top of the list at Duke is medicine, which like athletics, is synonymous with long hours, late nights and limited to no opportunities to explore the social lifestyle that many seek out when they leave for college. For anyone to combine the two vocations, it may appear at first glance to be impossible. But since 2005, a select group of female student-athletes have had access to an experience that is second to none in the premedical community.
CAPE, or Collegiate Athlete Premedical Experience, is a unique mentoring program at Duke that provides female student-athletes unparalleled exposure to the field of medicine. The program was incepted by Duke neuro-oncologist
Henry Friedman, M.D., and Chief of Neurosurgery
Allan Friedman, M.D., (no relation) and in its 15 years of existence, CAPE has placed over 100 such students who are now in medical school or beyond.
In recent years, the Duke rowing program has seen over 15 team members become involved in CAPE, with the results being current enrollment in medical schools both in the U.S. and abroad as well as careers in medicine. According to head coach
Megan Cooke Carcagno, it serves as a distinct advantage for young women with a passion for athletics as well as a high interest in working in the medical industry.
"The CAPE program is another example of the extraordinary advantages of being a student-athlete at Duke," Cooke Carcagno said. "Most universities of this caliber tell their students what they can't do or won't have time for. Duke sees a talented population – in this case female student-athletes – and finds ways to bring that group to the forefront of the medical community. It's the only school in the country enabling in this capacity and it's truly reflective of the Duke Difference."
While CAPE was officially introduced as a premier opportunity for female student-athletes in 2005, the idea was born nearly six years earlier, when Henry Friedman began mentoring a Blue Devils women's basketball All-American and medical hopeful.
"In 1999, I met
Georgia Schweitzer – now
Georgia Schweitzer Beasley – who was a big athlete on campus," Friedman said. "She was the one who took us to the first Final Four, when we beat Tennessee in 1999 at the Greensboro Coliseum. My daughter met her at a basketball camp when Georgia was rehabbing. My daughter was 11, played basketball and worshipped Georgia, and she told her that my wife and I were both doctors. Georgia wanted to be a doctor. Sarah [Friedman] made that connection for us. Georgia started seeing patients and was brilliant and was the prototype for CAPE."
In the following years, and even during Beasley's brief WNBA career with the Minnesota Lynx, Friedman made a consistent effort to provide help wherever needed to keep Beasley's dream of being a doctor alive. He would have her alongside to see patients, granting her clinical exposure that few pre-med students in the world can equal. Fellow CAPE founder and renowned neurosurgeon Allan Friedman would teach her how to perform neurological exams. Through Beasley's upbringing in the field, now culminated in her position as a surgical oncologist at Duke, both Friedman's saw a unique opportunity to provide a similar experience to other female student-athletes that was not offered anywhere else.
As it was being developed into a program, Henry Friedman asked himself the question, 'How are we going to get a collection of students who were already pre-screened?' He knew that to get CAPE off and running, it would need a presence that could relate directly to those who would be enrolled in the program. That presence was
Terry Kruger, a former athlete herself at Minnesota, where she became the first female on varsity scholarship while pitching for the Gophers' softball program.
"She joined in as the associate director and we just exploded," Friedman said. "It started off slow with a small number of students, and then as the word got out and TK played the pivotal role in getting to know the different coaches and explaining to them that it was good for their program, but it was also good for their recruiting."
That recruiting would go beyond enticing high school athletes who were interested in medicine, as Kruger found success using the blueprint of former CAPE participants to encourage both Duke coaches and the families of athletes who all may have been hesitant to see a college freshman try to navigate both pursuits.
"I used Georgia, I used Emily Waner and I used a lot of the kids from our very first classes in saying this is what we did," Kruger said. "Our basketball coach was our easy buy in for a couple of years until she left. She knew the quality of people that she wanted on her team were the same quality of what we wanted in a doctor, so we worked it out and I got to know all of the coaches, watched a lot of games, sat with a lot of parents and I think that's how we got a pretty good base of people back when we started in 2005."
The dynamic that Henry Friedman and Kruger share has evolved into an unmatched method of giving female student-athletes exposure and setting them up for success in medical school, while also understanding that the workload of being an athlete and a pre-med student calls for attention in itself.
"TK handles the basic social and emotional welfare of the students, which is at times fragile, as you'd expect," Friedman said. "I deal with the academic side in terms of writing the letters, talking to the deans of different schools, helping them if there are questions about one or another professor that's being sticky and TK will steer them to me. She's the mom and I'm the dad of these students, and it's worked out to be a very good relationship. Allan – I guess he's the great uncle. He's not there every day, but when he's there, he brings in an articulate analysis of a lot of the different things we discuss."
For members of the rowing team, both current and former, CAPE has been a tool that offers multiple benefits during their undergraduate years. One such alumna is
Katherine Maitland, a 2018 graduate who is now in the process of earning her medical degree at the University of Oxford. According to Maitland, the presence that Blue Devil rowers had in CAPE was one aspect that led to her coming to Durham from London.
"It was something that was talked about on my recruiting trips," Maitland said. "Definitely one of the things that drew me to Duke was the CAPE program. At the time, I wasn't sure about medicine. It was something I had sort of thought of in the last couple of months in high school. At the time, there were always a couple of girls in each class that were in CAPE. There must have been about a quarter of the rowing team when I joined that were members of CAPE, so it made it really easy to get involved."
For Class of 2019 graduate
Anna Jenkins, the opportunity to compete for Cooke Carcagno's squad came as a secondary interest, as her decision to attend Duke was first and foremost due to the university's academic prowess. However, quickly after Jenkins decided to walk on to the team, she realized how much of a support system there was built into CAPE, making her involvement in the program all the more appealing.
"That was definitely nice," Jenkins said. "I remember I had a senior on the team in my physics class with me freshman year, and that was nice to get to know a senior outside of practice. It was one of the captains and I was just a walk-on. People had shared their previous notes and there were old textbooks in the locker room. We have a big bookshelf of those. There was definitely a lot of respect for studying. There was no shame ever in missing a social event to go study – it was very supportive, so I appreciated that."
What separated CAPE from other pre-med programs around the country, however, is the premier access that the student-athletes receive in addition to their undergraduate studies. According to Jenkins, this exposure to what a typical professional physician might see offered something she knew she could not find elsewhere.
"It's a great program otherwise, but nothing else compares to this and it's why it's so cool – it allows student-athletes to shadow clinically," Jenkins said. "You can spend one morning a week for a semester shadowing in the brain tumor clinic. You shadow there with a lot of training, and you learn to take the basic patient history to present to the attendees. Once you complete that, then you can spend a summer shadowing in a variety of different clinics. There was dermatology, hand surgery, a diabetes clinic, esophageal cancer, melanoma clinic – just so many. That exposure is unparalleled."
As Kruger puts it, the shadowing experience and the ability to interact with patients sets CAPE students apart in the process of medical school admissions as well.
"It definitely is the one thing that sets them apart from other kids going to med school," Kruger said. "It shows in their interviewing. A lot of kids at Duke pre-med say they've volunteered, but our kids are talking to patients that are dealing with a brain tumor. They may have just found out that their whole life is altered. They go in by themselves, they learn to be calm, caring and by the end of their senor year, they're pretty darn good."
So good that, even according to Friedman himself, "They're better than some of our house staff. They're senior medical students. They're just very sophisticated in their ability to take a patient history and just come across as a compassionate, caring human being."
One aspect of CAPE that Maitland feels made a significant impact in her development as well as her interest was the summer internship program. During the six-week internship, CAPE student-athletes shadow in numerous departments, giving them a broad scope of all possibilities that they can explore when moving forward in their aspirations of medical careers.
"You do six weeks in the summer in the hospital, and you shadow a bunch of doctors," Maitland said. "I did that my junior year, and doing that experience is when I knew I wanted to be a doctor. I was just walking around the hospital thinking, 'This is what I want to do.' I spent days in outpatient in this healthy lifestyles clinic, which is all about multifaceted ways to tackle obesity. They had a nutritionist, nurses, doctors, a physiotherapist and they tried to come at it through all angles. I got to scrub into some surgeries. I think that was probably the really defining moment."
Yet while the CAPE program can set female student-athletes at Duke up for success down the road in medicine, it is without question that a college life that is juggled between Division I rowing and pre-med courses can become significantly overwhelming. But as Jenkins indicates, having fellow athletes that can share in that experience, even when the schedule seems impossible to navigate, makes all the difference in one's decision to stick with it.
"It can definitely be a lot," Jenkins said. "One of my classmates was also pre-med, so that was really nice. It's just nice having people you can connect to and relate with. You're going to class tired and hungry and sometimes you haven't showered, but it's nice to sit down and have someone next to you that's going through it too. A lot of us utilized the tutor that was provided if you requested them, so that was helpful too."
According to Maitland, the fellow athletes that she got to be around through CAPE – both in rowing and other sports – helped reassure her that her goals were not only recognized, but supported, even while her other classmates took a more widely recognizable approach for pre-med students.
"Athlete pre-med kids aren't quite normal in the demands that are put on you," Maitland said. "You could be doing group work in your chem class, and everyone wants to stay up until 1 a.m. trying to study. That can get really frustrating, but having the other athletes around you who want to go to bed at 10 and want to get studying done at a reasonable time, and kind of know the time constraints on you – that can be really helpful. Having the recommendations of classes and orders to take classes and the extra help with notes and all that kind of stuff – it's the little things that add up and help, I think."
For Kruger, who primarily assists CAPE student-athletes through these emotional and psychological hurdles, one way she has found that makes a positive difference is to have the student-athletes discuss the difficulties they face amongst each other. While there is no sugarcoating that the experience is not for the faint of heart, Kruger surmises that the empathy shared within the group can provide both consolation and motivation.
"I think it can [become overwhelming]," Kruger said. "They're tired. I think when they go to sleep, they go to sleep. They'll say 'I fell asleep on the floor because I was reading.' I think being able to talk about it and having a safe place to talk about it, whether it's clinic or when we do our journal clubs, they're saying 'I'm getting really tired.' Then, everybody chimes in and says it's OK. We don't let them have their butt kicked alone. All the kids are right there."
And even though the main goal of the program is to put female student-athletes in the best position as they pursue medical school studies and beyond, one thing that Friedman finds is the benefit of learning that one may not be interested in a medical career early in the process. This realization, according to him, comes early, but with the mindset that young women enter the program with, not often.
"I think what they understand and learn very quickly is what exactly the life of a physician is going to be like," Friedman said. "But 95 percent of our people in CAPE go on to become M.D.'s."
Perhaps a less drastic change than dropping medicine altogether that Friedman has noticed is the redirection in medical discipline among CAPE students. Once again, this decision can only be made through the exposure that the student-athletes receive, and the first-hand look into a multitude of occupations that can be held in the field of medicine.
"They see everything," Friedman said. "TK sets up summer internships and they're seeing every discipline in the medical center. All the athletes have seen orthopods during their career – they all get hurt – so they want to be an orthopod. Or, they love kids and they want to be a pediatrician. But then they see medicine, radiology, ER medicine – we've had everybody doing everything all over the country. Just like a medical student chooses, when you go through the rotations, you learn what appeals to you and then you get to choose your career path."
According to Maitland, the CAPE program not only gave her a leg up in her applications for medical school, but it also taught her about her own abilities that she may have not given herself credit for beforehand. While most pre-med students go into their next phase of studies without ever interacting with a patient, she was able to discover that it is just that which sparked her interest even more.
"If I hadn't been a part of that, I don't think I would have gone to med school," Maitland said. "I think I would have gone into research and done something else. I think for me, seeing the patient interactions and being able to actually have conversations with patients is really monumental in my decision to become a doctor. It surprised me a little bit, because I thought that I was always a bit shy and awkward, but I actually really enjoy chatting to patients and getting to know them. Even now, when I started my degree, I noticed how much I enjoy having a chat to the patient and developing those relationships."
With this unparalleled clinical exposure, and as CAPE continues to produce more and more female doctors, medical schools around the country and the world have taken notice. As Kruger states, the knowledge the CAPE students have during their first semesters of medical school garners the attention of both professors and the student-athletes themselves.
"We teach them to do a physical and a neuro exam," Kruger said. "They're in there talking to patients, come back out and present to the physician that's in the room. The first several weeks of med school, it's my favorite time. They'll call and text saying 'Nobody knew how to do it, but I did it.' It gives them a big leg up, because they know how to talk to patients, they know the lingo, they've learned our second language of medicine, so they feel so much more comfortable. The more we get known throughout the country, the more different schools say 'Oh, you're a CAPE kid.' They know us."
Jenkins added, "I think for med school, when you apply with this experience, they can see that you know what you're getting into, so they like that. Also, if you were to do a gap year, which most pre-med students are doing now, with this exposure you have a lot more opportunities. For gap year positions, I felt like a lot of doors were opened for me because I had all this clinical experience and they wanted someone that was comfortable talking to patients, comfortable in vulnerable situations, and had been trained how to communicate effectively and respectfully. It definitely gives you an advantage."
But as Jenkins has learned, it is not only the medical knowledge and advantages that CAPE provides that set its students up for success down the road. Even in its most stressful times, she knew that navigating that lifestyle of athletics and her studies would teach her lessons that go far beyond both interests.
"It was rewarding," Jenkins said. "It's definitely overwhelming. It wasn't the time balancing schoolwork and rowing that would've pushed me to leave the team. That was hard, but I think it teaches you really valuable life skills and you can adapt to that. It takes a little bit of a learning curve, but there's a lot of resources to help you. For some people, it is too much, but I think if you are willing to reflect and question 'How can I study more effectively? How can I use my time more effectively,' you can figure that out. It's more that rowing and school are emotionally overwhelming. Emotionally, it can be a lot to do both, but I think getting through that can really help you in life."
Since Duke rowing has become consistently involved, Cooke Carcagno has made it a point to recognize the team members in CAPE in a unique way. If you look on the Duke boats for pairs, you will find names such as
Meg Lew,
Tara Christensen and
Alex Stonehill – all former rowers who studied and learned within CAPE. In the next few years, perhaps it will be names like
Savannah Herbek,
Amelia Shunk and
Molly Pleunneke – current rowers in CAPE – that will be painted onto the boats as the association between Duke rowing and the Duke pre-med program continues.
"I started naming our pairs after women who participate in the CAPE program, row for all four years, and donate to the team," Cooke Carcagno said. "The CAPE program takes undergraduate women and helps them towards med school. We use our pairs to turn our rowers into fast, big boat movers. The symbolic relationship is something to celebrate and show everyone in our boathouse that excellence knows no boundaries. I'm proud of the women who have achieved this distinction and I'm happy to support the women who will continue to do so."
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