Former Editor-in-Chief (2021-2022)
Icahn School of Medicine at Mount Sinai
Alina is a fourth-year medical student at the Icahn School of Medicine at Mount Sinai in New York City. In 2018, she graduated from Barnard College with a Bachelor of Arts in neuroscience & behavior. She enjoys poetry and drinking chai in her free time.
Welcome! As the 2021 academic year begins for medical students across the country, it brings with it the age-old challenges of studying medicine. As you continue your journey through medical school, we hope that in-Training provides you with a community for discussion, reflection and support when you need it most.
A 5-year-old African-American boy presents to the emergency department with left leg pain. His leg is exquisitely tender to palpation… If I read this vignette in the first year of medical school, I would have navigated to the multiple-choice answers to select anything related to sickle cell disease. The question writers are stating that the patient is Black, young and has a painful limb — this is not a difficult diagnosis.
I was raised by two physicians who did not “differentiate” until well into their rotational year, and they did, as their generation tends to say, “just fine.” But the reality is that what was “just fine” for physicians-in-training even one generation ago is no longer as feasible.
I often joke about how worthless my art history studies were, but I never mean it. The truth is that my training in the humanities, while being unconventional for medicine, has prepared me to be a better physician and clinician.
It was 5 p.m. on a Thursday and I had just finished my first preceptorship session with my fourth-year medical student preceptor. That afternoon was one of many firsts, as it was also the first time I conducted a patient interview. My first-ever patient was a middle-aged woman in the emergency room talking to me through Zoom. I remember introducing myself nervously, stuttering on the few syllables that make up my name, and then asking what brought her to the hospital.
The first thing I notice are his boots. He’s still in his street clothes, having just been admitted. He looks thin, emaciated — his clothes hang off him, shirt collar drooping down from his neck like peeling paint. His boots, however, seem to fit him properly. They look warm, well-worn but sturdy, like they have weathered a hundred bitter winters and could withstand a hundred more. For some reason, this comforts me.
In this episode we interview Dr. Tait Shanafelt. Dr. Shanafelt is a Jeanie and Stewart Ritchie Professor of Medicine, Chief Wellness Officer, and associate dean at Stanford University School of Medicine.
For better or worse, I have always partaken in escapism in one form or another. “Escapism,” defined as the practice of avoiding a difficult reality by immersing oneself in distraction or entertainment, is a concept that rose in popularity in the 1930s as a natural reaction to the Great Depression of the previous decade. Although I did not know it at the time, I have been practicing escapism since 2000 BC (before COVID). As the eldest daughter of immigrants who were new to the continent and busy building a life from scratch, I would get lost in stories from a very young age. I had little in the way of friends and even less of an interest in being popular, so naturally I was drawn to books to fill that emotional void; novels were the way to my heart — fantasy and fiction, oh my!
For many of the elderly and their families, the COVID-19 pandemic has been a scary and trying time. A major concern has been the physical health and safety of this vulnerable population. In addition to community infection control measures like social distancing and avoidance of public gatherings to slow the initial spread of the outbreak, public health officials have also endeavored to protect high-risk populations by recommending electronic visits with loved ones, whether they are at private homes, nursing homes, or in the hospital.
The pressure and anxiety surrounding Step 1 is one of the main reasons cited by the USMLE to justify its adoption of a pass-fail grading system. However, many medical students are met with more trepidation about their future as this major anticipated change in Step 1 takes effect.
I hope my classmates, communities, and I all dance far more often with health than sickness. I pray that soon the last hospital bed holds the last patient with COVID. I hope justice and truth prevail. I hope we hold onto what we carry: the love of friends and family, a resilience tried and true, bravery unbridled and faith that we will persevere among the challenges life affords. I hope that after long days of caring for others, we care for ourselves and call a friend, a loved one, a therapist — and remember how far we’ve come. We have been patients, and we will be patients, even as we care for patients.
Presenteeism does not simply exist for seasoned providers; it seeps down the medical training pipeline and perhaps poses the greatest threat to trainees at the start of their careers. The fear of missing out as the “beginner on the team” can be paralyzing when there is so much important knowledge beyond us. Such pressure persists longitudinally, too, as trainees at every level fear that taking time off will appear as a lack of dedication to clinical education or will result in lower performance evaluations.
Trisha Kaundinya is an internal medicine-dermatology combined resident at Mass General-Brigham and Harvard Dermatology. In her free time, she enjoys cycling and cooking.
