Category: General

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General Reflection

Medical Conferences: Are they worth it?

Each year there are many medical conferences held around the world. These could be conferences about new research, medical education or, perhaps, a gathering of those in a specific specialty. Last year I was lucky enough to attend the American Medical Women’s Association (AMWA) Centennial Conference in Chicago, IL. After attending my first medical conference, I have made it a personal goal to attend at least one each year.

So, was it worth it? In my opinion, it is a definitive yes. I’ll break down some of the pros and cons based on my experience so you can decide for yourself if you’ll be attending a conference (or two) within your medical school years.

Pros

  1. Connections. I can’t go on long enough about how many new connections I made. I met physicians from around the nation in different specialties. I heard from speakers who had written books, gotten double board certified while raising a family of four, and even travelled to the moon (I’m not kidding, Mae Jemison was in attendance). An easy way to stay in touch with the new colleagues you’ve met is LinkedIn. After hearing from them at the conference I connected with them on LinkedIn, which allows me to see what they are doing professionally and keep them in my network for any future communications.
  2. Relationship growth within my organization. The AMWA chapter at my medical school has always been a tight-knit group, but this trip made many of us even closer. It was a great way to get the entire group motivated for an awesome upcoming year. We were able to bond over our favorite speakers and chat about some of the important issues being discussed on the women’s rights front.
  3. Stepping outside of your comfort zone. In advance, the conference paired student attendees with physicians and asked students to meet with and interview the physician. I ended up getting paired with an internal medicine physician coming from the renowned Tuft’s University. I was intimidated at first because she came from such a prestigious university, but she turned out to be incredibly down to earth and friendly. I had the opportunity to talk to her about her personal journey and how being a woman in a once male-dominated field affected her.  She told me a story of when she was involved in a patient’s care when they began coding. As if this weren’t stressful enough, she was seven and a half months pregnant and started having contractions. Womanhood presents unique obstacles, but this physician was able to overcome them with flying colors.
  4. Exploring a city! The conference allowed me to experience Chicago in a new way. We stayed right in the heart of downtown and went on quite a few sight-seeing adventures. Next year the AMWA conference is in Miami, which would be so much fun to visit! Heading out of town for a conference can feel like a mini vacation from the hectic life of a medical student.
  5. Intellectual growth. The AMWA conference placed a strong emphasis on the advancement of women in medicine. We heard from numerous female physicians about their experiences within the field and how they got onto their current path. It was empowering to listen to women who had written numerous books, founded various organizations and impacted society so greatly. Additionally, I was able to hear from numerous female physicians about raising a family and having their dream career. It gave me hope that the life I want is doable. I think this conference truly revitalized my energy after a long first year in medical school. It allowed me to see past the current grueling coursework to what my career could potentially blossom into.
Cons
  1. Money. Okay, to be honest, this AMWA conference was actually affordable, but I know many are super pricey. My advice is to seek funding from various sources. This year I’d really like to go to the conference again, so I plan to set up a Go Fund Me account that will allow my relatives to donate some money to help me attend. Last year, I was fortunate enough to get some money to support my travel. Most student organizations can get some funding from their school, which is what our AMWA group was able to do. In addition, many conferences have grants or scholarships to help students attend. I recommend looking at a few different conferences you find interesting and pick one that is the most economical. Another option is to create a poster (or research) to present and most likely you can get a grant from your school to present it at a conference.
  2. Time. The conference I went to was an entire weekend event, so I wasn’t able to study at all. In the little down time we did get, I wanted to explore the city or just relax for a few minutes. Plan ahead and study during the car (or plane) ride. Check your schedule and make sure the conference falls during a time that isn’t incredibly hectic for you. Even though conferences are a large commitment, the time “lost” I think ends up being an overall gain when you consider the benefits.
I think medical students should look further into the idea of attending a conference. Many of us are hesitant because we think it will just cost extra money we don’t have. I urge each of you to look deeper than the price tag and make a plan to go to a conference at least once during your four years of medical school. To find out more information about the AMWA Centennial conference click here.

Featured image:
Conférence NWX2012 by Frédéric BISSON


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General

“The Three Ingredients of Medicine” Dr. Myron Cohen, 2015 Commencement Address of UNC Chapel Hill Medical School

This week, Dr. Myron  Cohen’s 2015 Commencement Speech at the UNC School of Medicine entitled, “Becoming a Citizen of the World” debuts via the Medical Student Press.

Screen Shot 2015-10-01 at 9.25.18 PMDr. Myron Cohen is known for his invaluable contributions to the construction of the HIV Prevention Trials Network 052, which established that treating an HIV patient with antivirals makes them less contagious to their sexual partners.

Dr. Cohen earned his medical degree from Rush Medical College, completed his residency in internal medicine at the University of Michigan, and did his infectious disease fellowship at Yale University.

Dr. Cohen is the Associate Vice Chancellor for Global Health, the Yeargan-Bate Distinguished Professor of Medicine, Microbiology and Immunology and Epidemiology, Chief of Division of Infectious Diseases and Director of the Institute for Global Health and Infectious Diseases.

Dr. Cohen’s research work focuses on the transmission and prevention of transmission of STD pathogens. Dr. Cohen and his coworkers have identified the concentration of HIV in genital secretions required for transmission of HIV, and the effects of genital tract inflammation on HIV.

Dr. Cohen structured his speech based on three “ingredients” of medicine that are essential to identify: change, being a citizen of the world and humanity.

“Diseases do not respect borders… Tomorrow -wherever you go- you might well be asked to deal with a patient from West Africa at risk for Ebola, or to make recommendations about measles vaccination.”

He continues by advising graduates to remain compulsive and balanced or the pleasure and significance of medicine may be harder to appreciate. He then concludes with reminding graduates of the privilege they now have of being physicians:

“And with this privilege and recognition comes responsibility: the responsibility to do your very best for your patients; the responsibility to contribute to the health of people in your community; and the opportunity for leadership for the graduates of UNC who will move to communities all over this great state.”

Read Dr. Myron Cohen’s full commencement address.

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General Lecture

Hazardous Attitudes

A few months ago I attended a medical conference organised by The Medical Student Journal Club in Slovenia. The conference consisted of debates between medical students, which is a great concept that I thought worked very well. Two medical students, usually from different countries, take on the same topic, one presenting the Pro side and the other the Contra side. They have a short Powerpoint presentation, after which the audience is invited to comment and ask questions. This was the third Pro et Contra congress I attended, having been an active participant each year since it was first organized. It was an easy decision to come back each year because it’s different than the medical conferences I’m used to. It takes place during the weekend, and it’s a perfect blend of learning about medicine in a more interactive way, sharing opinions with my peers and senior doctors, meeting medical students from different countries and having a nice time exploring Slovenia. Not to mention the organization is absolutely amazing, with every moment of our stay taken care of.

I realize most of the readers of this Blog are from the USA, and the likelihood of one of you visiting this medical congress in Slovenia is very low. I’d be happy if I got more people to attend the Pro et Contra congress; however that’s not what this post is about. Even though the debates at the last Pro et Contra congress were amazing, the opening ceremony involved a group of doctors performing a few popular song parodies on different medical hot topics, the audience participated in discussions more than ever before, and I went home with a prize for the best foreign speaker (a generous gift of Harrison’s manual of medicine), what made the biggest impact on me was the guest lecture given by a pilot, captain Tomaž Prezelj. Yes, a pilot gave a lecture at a medical conference, and it was simply superb. It is almost two hours long, but I advise you to take time out of your busy schedule to watch it. Captain Prezelj compares five different attitudes of pilots and the ways they can affect flight safety. The great responsibility, human nature, and high risk environment pilots work in easily translate to the experience of doctors and medicine. It’s all about human error. So, without further ado –

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General

“The Power of Giving Hope” Chancellor Bill McRaven, 2015 Commencement Address of the UTSW Medical School

This week, Chancellor Bill McRaven’s 2015 commencement speech at UT Southwestern Medical School entitled, “The Power of Giving Hope,” debuts the Medical Commencement Archive.

Screen Shot 2015-09-25 at 9.52.28 AMBill McRaven, who recently retired as a four-star admiral after 37 years as a Navy SEAL, became Chancellor of The University of Texas System in January 2015.

McRaven also is a recognized national authority on U.S. foreign policy and has advised the President, Secretary of Defense, Secretary of State, Secretary of Homeland Security and other U.S. leaders on defense issues.

In 2012, Foreign Policy Magazine named McRaven one of the nation’s Top 10 foreign policy experts and he was later selected as one of the Top 100 Global Thinkers. He served as primary author of the President’s first National Strategy for Combatting Terrorism and also drafted the National Security Presidential Directive-12 (U.S. Hostage Policy) and the counter-terrorism policy for President George W. Bush’s National Security Strategy.

McRaven graduated from The University of Texas at Austin in 1977 with a degree in journalism and received his master’s degree from the Naval Postgraduate School in Monterey in 1991.

Chancellor McRaven begins his speech by boldly listing the very real responsibilities and expectations that graduates now have as residents and doctors in practice:

“As a patient, I want my doctor to be smarter than I am. I want them filled with knowledge and I want them to understand how to use that knowledge to confront the challenge before them… As a patient, my doctor must at all times be in command – in command of themselves, in command of people around them and in command of me.”

He continues by narrating his personal experience as a patient with Chronic Lymphocytic Leukemia and the life-altering and healing power of hope that one physician gave him:

“All because one man gave me hope.  Because one man healed me of my greatest malady: fear.

Above all else, as doctors, you must give your patients hope.  Even under the most dire of conditions, hope can heal.  Hope surpasses all our understanding.

Hope is the medicine that gives smiles to the forlorn, faith to the disenchanted and life to the dying.

Give your patients hope.”

He finishes by reminding graduates that although delivering bad news can be spiritually crushing and debilitating enough to push physicians into an emotional separation from patients, maintaining compassion and faith is a moment that patients will remember forever:

“A thousand moments to restore their faith, a thousand moments to give them hope, a thousand moments to heal their wounds and to show them the love and compassion that every great doctor must possess.
And that first moment begins right here and right now, because for now and evermore, you will be the doctor.”

Read Chancellor McRaven’s full speech here.

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General

“Where There Are Challenges, There Is Huge Opportunity” Dr. Paul Klotman, 2015 Commencement Address of the Baylor College of Medicine

This week, Dr. Paul Klotman’s 2015 Commencement Speech at the Baylor College of Medicine entitled, “Where There Are Challenges, There Is Huge Opportunity” debuts via the Medical Student Press.
Dr. Paul Klotman began serving as President and CEO of Baylor College of Medicine in 2010. He
received his Bachelor’s degree in 1972 from the University of Michigan and his M.D. from Indiana University in 1976. He completed his medicine and nephrology training at Duke University Medical Center. In 2001, he was selected to be the Chair of the Samuel Bronfman Department of Medicine of the Mount Sinai School of Medicine. The BCM Board of Trustees named him as the school’s new President in July of 2010.

Dr. Klotman’s research has been a blend of both basic and clinical research in molecular virology and AIDS pathogenesis. He developed the first small animal model of HIV-associated nephropathy using transgenic techniques. He is on the editorial boards of journals in both the United States and in Europe and he has served on and chaired numerous study sections including those from the NIH, the American Heart Association, the National Kidney Foundation, and the VA research service.

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At Baylor College of Medicine, he oversees the only private health science university in the Greater Southwest, with research funding of nearly $400 million. The medical school is ranked as one of the top 20 for research by U.S. News & World Report and first among all Texas colleges, universities and medical schools in federal funding for research and development.

 

Dr. Klotman begins his address by jumping right into the topic of ethical consequences when medical expenses influences treatment options:

“How do we measure it and how do we make sure we do the right thing even if it costs more? …All this sounds good but unless we deal with the costs of intervention and the costs of end of life care, we will struggle to bend the cost curve significantly.”

He further discusses the continued issue of the uninsured poor, despite government and local changes, and the graduates’ role in being catalysts of improving the opportunities that the underserved have in attaining medical care:

“But where there are challenges, there is huge opportunity. And the opportunities in health care have never been greater. Whether it’s new approaches to the discovery of drugs, transformational technologies to expand access to or delivery of care, or novel ways to approach the health of populations, the opportunity to innovate and transform has never been more apparent.”

Click here to read Dr. Klotman’s full speech.

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General Mentorship MSPress Announcements

“Going Forth with Compassion” Dr. Ruth Lawrence, 2015 Commencement Address of the University of Rochester School of Medicine

This week, Dr. Ruth Lawrence’s 2015 commencement speech at the University of Rochester School of Medicine and Dentistry entitled, “Going Forth with Compassion,” debuts the Medical Commencement Archive. This address was a personal favorite to read and a great reminder for those of us still studying in our medical school caves, as well as those starting their life in residency.

Dr. LawrenceDr. Ruth A. Lawrence, MD, is a graduate of Antioch College and the University of Rochester School of Medicine and Dentistry. She is a pediatrician, clinical toxicologist and neonatologist. She is Professor of Pediatrics and Obstetrics and Gynecology at the University of Rochester School of Medicine and Medical Director of both the Ruth A. Lawrence Poison and Drug Information Center and of the Breastfeeding and Human Lactation Study Center. She became the Director of the Poison Center at the University of Rochester in 1958 and wrote on the management of household poisonings with Dr. Robert Haggerty, Chair of the Department of Pediatrics and former Director of the Boston Poison Center. She has been a member of the New York State Association of Poison Centers since its founding and has served as its President twice. In 2002, Dr. Lawrence received the Life Time Achievement Award from the American Academy of Clinical Toxicology.

Dr. Lawrence begins her speech with the almost-intimidating reality of graduating from medical school:

“You are about to embark on the most challenging year ever.  Medical school pales by comparison because before you were the student, you were there to learn but it was someone else’s responsibility.  In a few weeks, you will be the doctor of record, what you do may save a life, solve a problem, or change the course of an illness.”

She reminds the class that despite the advances in technology, treatment plans and hospital protocols, and despite the efficiency of a quick reference to “Google,” nothing will ever replace the significance of simply listening to your patient and being compassionate.

“The key to being a good doctor is to really care about your patient.  The science will come and go, but the best doctors understand people, REAL people, and are good communicators. Listen when patients talk, listen completely.”

Dr. Lawrence concluded by reciting a short quote:

The purpose in life is not to be happy, it is to matter

To be productive and responsible

To be honorable

To be dedicated to goals higher than self

To have it make some difference that you lived at all.

Click here to enjoy Dr. Lawrence’s full address.

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General Opinion

You don’t belong here; are you even a real doctor?

Disclaimer: This is written with the sole purpose of increasing awareness.

Rare things are valuable.  They stand out.  They generate intrigue.  However, they can also make people apprehensive.

There is a misconception that naturopathic doctors are quacks who couldn’t get into “real” medical school, and don’t know what they’re talking about. But there is a big difference between naturopaths (online certification) and naturopathic doctors (four years at an accredited institution). At age 23 I had been to nearly 20 different MDs and was ingesting 10 different medications each day until I saw a naturopathic doctor (ND) who turned everything around. Not only did my health change, my career choice did as well.

Naturopathic Medicine is a distinct primary health care profession that combines natural healing techniques with modern science.  It is a whole-person approach tailored to each patient and focuses on finding the root cause of the health issue. NDs are well versed in treating chronic illnesses and emphasize preventative medicine, but can also aid in acute care. By combining natural healing methods with modern scientific principles and technology, naturopathic medicine genuinely embodies modern integrated health care.

There is a time and place for everything. NDs are trained to know when referral or higher intervention is needed. It is time to erase the battle lines because the “us versus them” mindset is not beneficial to patients. Furthermore, MDs and NDs are more similar than it may seem.

We all have the same ability to heal and treat our patients. Although the manner in which we go about treating our patients may be different, we are all trained in basic and clinical sciences, including biochemistry, anatomy, physiology, pharmacology, and even minor surgery. NDs have additional training in nutrition, botanical medicine, and counseling, while MDs have added training in pharmacology and more clerkship hours. Both cohorts complete clinical training and take board examinations in order to become licensed professionals.

We have similar struggles. We sit through hours of classes only to go home and study until we fall asleep. We sacrifice our social lives for our scrubs. We are more up to date on the latest neuroanatomy YouTube videos than we are on episodes of Game of Thrones. We go home at the end of the day smelling like dead bodies and bodily fluids.

But aside from these things, we have the same end goal. We are all detectives, trained to combine history, lab tests, imaging and physical examinations to understand the patient. While NDs typically don’t advocate drugs at the first sign of trouble, we are still trained to prescribe them.

There is an underlying assumption that only pharmaceuticals are “real” medicine, while nutrition, exercise, and lifestyle interventions are “fake” medicine. In actuality, real medicine is whatever works, and the most important aspects of patient care are things that cannot be quantified or measured, but can instead be conveyed and experienced.

Partnerships require a lot of work. Nonetheless, patients need and deserve the services of both MDs and NDs.  Therefore, we should work to understand and respect each other’s profession.  Our skills complement each other and by working together our patients will receive the greatest benefit.

Featured image:
Apple for Health – Apple with Stethoscope by Wellness GM

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General MSPress Announcements

“More Than a Diagnostic Code” Dr. C. Garrison Fathman, 2015 Commencement Address of the Washington University School of Medicine in St. Louis

Screen Shot 2015-08-26 at 7.47.02 PMThis week, Dr. C. Garrison Fathman’s 2015 commencement address at Washington University School of Medicine in St. Louis entitled, “More Than a Diagnostic Code” debuts via the Medical Commencement Archive.

Dr. Fathman is a Professor of Medicine in Immunology and Rheumatology at Stanford University School of Medicine. Dr. Fathman received his M.D. from Washington University in St. Louis in 1969, completed his residency at Mary Hitchcock Memorial Hospital in 1971 and his fellowship at Stanford University School of Medicine in 1973.

He is currently the Director of the Center for Clinical Immunology at Stanford and Division Chief of Immunology and Rheumatology, and a former President of the Clinical Immunology Society and the Federation of Clinical Immunology Societies.

Dr. Fathman’s primary research focus in molecular and cellular immunology continues to lead the way in discovering the mechanisms of T-cell anergy and the pathophysiology and immunotherapy of preclinical animal models of autoimmune disease.

Dr. Fathman begins his speech by recollecting a somewhat nerve-wracking situation in his medical school rotation and reflecting on the importance of remaining humble in the face of knowledge:

“…you have an abundance of knowledge gained over the years of study already committed to this profession, but a dearth of practical experience. It is critical that as you enter into practice, you maintain a sense of humility in your knowledge as you interact with your patient.”

He continues by describing the dramatic changes in medicine as technology surges to the forefront of patient care, and encourages students to interact with patients physically and emotionally instead of simply recording information into a computer:

“…you must remember that the more skilled you become, the more specialized you become, and the more dependent on technology you become, the easier it becomes to lose your humanity by discarding your compassion and connectivity with your patient. You must continually strive to maintain your compassion and connectivity with your patient. This will allow you to maintain your humanity.”

He closes by reminding student to embrace the uncertainty of science and the opportunities it opens:

“Trust the education you received at this internationally esteemed medical school to help you make the right probability-based decisions, but don’t stop learning; continuing education is a life long requirement of the medical profession.”

Categories
General Lifestyle

Coffee

Coffee. A 6-letter word that I am sure soothes the souls of many medical students around the world, including my own. That dark, rich color. That tempting, invigorating smell. I honestly can’t imagine my mornings without that cup of coffee. A full cup of homemade Starbucks coffee with a dash of almond milk and some sort of sweet pastry- the ideal morning routine that gets me going. However, ever since my first day of medical school, it doesn’t just stop at that morning cup. There’s a lunchtime Starbucks run, maybe one after class at 5, and don’t forget those evening teas, which average around 40 mg of caffeine per 8 fluid ounces! Come on, how else do my professors expect me to keep up with my daily studies?!

An article written in Medical News Today, entitled “Coffee drinking habits may influence risk of mild cognitive impairment”, discusses a study that has opened my eyes to just how much of an influence our coffee drinking habits could have on us! Drinking coffee, an act we think is going to wake us up so we can study and retain more, is in fact doing the COMPLETE opposite. It is not exactly the act of drinking coffee that is detrimental to us, but the pattern in which we are doing so. The article presents a study presented in the Journal of Alzheimer’s Disease, following the drinking habits of people between the ages of 65 and 85. The results they discovered are truly amazing! As quoted by the article’s author, Honor Whiteman, the results of the study revealed that “cognitively normal participants whose coffee consumption increased over time were also around 1.5 times more likely to develop MCI than those whose coffee consumption remained stable – no more or less than one cup of coffee each day”. Furthermore, “participants who consistently drank a moderate amount of coffee – defined as one or two cups daily – were at lower risk of MCI compared with those who never or rarely consumed coffee”. Who knew changing the AMOUNT of caffeine one drinks over time could have such a major effect on one’s memory and cognitive abilities?

It is very interesting to me that if you just keep a consistent, stable, predictable amount of intake, coffee has not shown to be detrimental for the body. This just goes to show that too much of anything is simply not good for you. Even though the pool of subjects was older in this study, there is definite potential that the correlation found could apply to the younger population. Once we near that final exam, and we start upping our intake to two, then three, then four cups a day, that is when the damage might ensue. This is the point I wanted to highlight. Trust me, I understand at that moment, at 1:00am in the middle of the night, you feel like that warm, steaming cup of coffee is the only thing keeping you from having a meltdown and simply giving up. However, I just want to call to your attention the possibility that the change in our coffee drinking patterns could actually be hindering our cognitive abilities, instead of helping. Next time you go to your Mr. Coffee to make that 4th cup of the day, please step back, and think of another alternative that could wake you up and recharge your engines. Perhaps a quick run. Maybe a phone call to an old friend or family to change your mindset. These are all possible substitutes that could work, if given the chance, AND that do not have such destructive effects.

Featured image:
cup of coffee by cactusbeetroot

Categories
General Reflection

Can Empathy Be Taught?

As medical students, we are taught to examine patients, recognize symptoms, and treat diagnoses. We get lost in the sea of differential diagnoses and worries of exams. I always worried that I’ll never remember all the important facts, that I’ll miss an important sign or symptom or forget an essential part of treatment in an emergency situation. When I faced my real-life patients, I realized that I was indeed not ready. Surprisingly though, it wasn’t the lack of theoretical or practical knowledge that worried me anymore, but the fact that each patient required a different approach. Some patients are serious and to the point, others are full of witty remarks about not only their condition, but all sorts of topics. Some don’t want to know much about what’s happening to them, while others have countless questions. Their behavior might be a part of their usual personality, or it could be changed because they have found themselves in a new, often scary situation. I wanted to, had to, understand why each of my patients acted and thought the way they did, so that I could adapt my manner, make them more comfortable, find out more information, and finally, earn their trust.

In observing my seniors, doctors with years or decades of experience, I have noticed their style of communication with patients comes from every part of the spectrum. Some are empathetic and communicative, dedicating a large portion of their time to their patients; others are introverted, avoid communication with patients at all costs, or can even be patronizing and show little understanding.

In the past, medical education focused primarily on academic knowledge and practical skills. Today, however, the importance of doctors’ communication skills has obviously been recognized and integrated in our education. But can empathy be taught?

We can learn to shake a patient’s hand, to ask for permission before examining them, to perform other small actions that take little effort but make our patients much more comfortable. In order to better understand our patients, to get them to open up more easily and reveal parts of their medical history they would otherwise conceal, to treat them in the most individual manner possible, we need to empathize with them. I’ve seen my colleagues to whom this comes naturally, but I’ve also seen others whose attempts at empathy take a lot of effort and energy.

Because I am at the very beginning of my medical career, I realize my point of view might be naive. Still, at this point I believe I should focus on each patient. I should empathize and understand each individual fully before attempting to tend to his or her troubles, however much energy that takes. I am also worried about the possibility that this ability can be lost. I often wonder if the more reserved senior doctors have always been that way, or if their energy and will to empathize have been lost after seeing innumerable patients.

I don’t know if empathy can be taught in classes, but I do believe everyone can develop it. Unfortunately, I think the ability to empathize can also be lost. Ultimately, this social dimension of medicine remains different for each health professional, and their ability or will to empathize remains their choice, depending on how they choose to integrate their theoretical knowledge and experience with their personality.

Featured image:
empathy by Sean MacEntee