An Uncertain Future: Studying Medicine in a Wounded City

This article was exclusively written for The European Sting by Ms. Andser Fernanda Avilés Martínez, a fifth-year medical student at the Autonomous University of Sinaloa, Mexico. She is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

For medical students, the vocation to help others is often stronger than fear. It is the conviction that, despite fatigue and hardship, we are here to learn how to save lives. However, in cities like Culiacán, Mexico, violence has become a harsh reality for those who aspire to become doctors. Armed confrontations, threats to hospitals, and attacks on healthcare personnel have created a climate of fear that forces many young people to question their future in the city: What happens when, instead of worrying only about exams and rotations, we have to wonder if we will make it home safe and sound?

We know something is wrong. We feel it every time we hear about ambulances being attacked, we confirm it when we read about armed groups entering hospitals, and we think about it each morning as we check the news alerts before leaving home. We are reminded of it when a colleague decides to abandon their studies or, in the worst case, when one of us is no longer here.

Fear as a New Challenge in Medical Education

For medical students in Culiacán, daily routines have changed. Public transportation is no longer a safe option after certain hours, and night shifts in hospitals feel more dangerous than ever. Some students have reduced their shifts in specific areas—not due to a lack of commitment, but because violence does not distinguish white coats.

In Culiacán, caring for patients now means facing not only disease but also the ever-present threat of violence erupting at any moment. Recent attacks on ambulances and healthcare workers have spread fear among students and interns, who feel vulnerable even within hospital walls. 

This grim reality has forced many students to make a painful decision: take the risk and finish their degree in Culiacán or move to another state and start over. For some, leaving is unthinkable—whether for economic reasons or simply because they cannot bear to abandon what they have worked so hard to build. For others, leaving is the only way to ensure their safety.

We know that hospitals in Culiacán need doctors, that the community relies on us for care, and that leaving would only deepen the region’s healthcare crisis. But at what cost?

A Public Health Crisis Ignored

While armed conflicts in other parts of the world are acknowledged as humanitarian crises, what happens in cities like Culiacán continues to be overlooked. Violence does not only claim lives in the streets—it leaves deep scars in hospitals and medical classrooms.

This is not just a security crisis; it is a public health crisis. If the medical community and authorities fail to take urgent action, the exodus of healthcare professionals will persist, leaving a wounded city with an even more fragile health system.

Not all of us will make it to graduation—not because the path to becoming a doctor is too difficult, but because violence has taken some of our classmates from us too soon. 

About the author

I am Andser Fernanda Avilés Martínez, a fifth-year medical student at the Autonomous University of Sinaloa. I have actively participated in research projects focused on public health and scientific advancements. I am a member of the local Student Academy (AEMUAS), where I have held various positions for three years. I collaborate as a editor for the SoyAMMEF journal and served as Project Coordinator for the national AMMEF team during the 2023. In 2024, I completed an international research internship in Poland. I am passionate about medical research and committed to contributing to scientific progress and improving healthcare.