Contributing Writer
University of Miami Miller School of Medicine
Lara is a third-year medical student at University of Miami Miller School of Medicine in Miami, Florida class of 2022. In 2017, she graduated from University of Miami with a Bachelor of Science in neuroscience. She enjoys walking with her dog Mila, cooking, and hosting wine and cheese nights in her free time. After graduating medical school, Lara would like to pursue a career in psychiatry.
I was patiently sitting in the lobby at Quest Diagnostics, waiting for the staff to slowly let people inside in adherence with the new social distancing guidelines. I waited for about ten minutes before a man in his mid-50s called my name and led me into a patient room.
In this episode, we interview Dr. Edward Barksdale. He is the newly elected American Pediatric Surgery Association president. He is also the division chief of pediatric general surgery and thoracic surgery at UH Rainbow Babies and Children’s Hospital.
The Iranian Consultative Assembly, the equivalent of a parliament, legalized living non-related donations in 1988 and set up a new government-run transplant matching system. Within this novel framework, living donors could choose to have their organs typed and registered in advance. If they are needed, a third-party independent organization, the Dialysis and Transplant Patients Association (DTPA), would set up contact between the donors and recipients. The donors would be compensated by a payment from the government, free health insurance, and sometimes additional payment from the recipient. The payment from the government is said to be in the range of $2,000-$4,000.
I am sitting in school / but I am also thinking of you. / Yes, I do / wonder how consciousness / wraps round and round / this hunk of meat, / how chunks of flesh / sustain your metaphysical feat.
I no longer feel alone the way that I did the first few weeks of dissections, because now I recognize that my peers were sectioned off at their tables also worried that they were losing their sensitivity, that they weren’t good enough to belong, and they didn’t know how to cut into a person. I wish that I had known what my classmates were thinking and feeling during the anatomy course.
To understand the issue surrounding assessments, we must understand that it has become increasingly challenging to train physicians suited to face contemporary changes. To future physicians who have access to a repository of ever-expanding information on their smartphones, being tested on ‘high-yield’ minutia serves little purpose. Being able to think critically (and perhaps even imaginatively) in order to make sense of that information for patient care is what counts. And thus, no matter how standardized an examination is, lack of contextual reference renders it futile.
In this episode we interview Dr. Ijeoma Nnodim Opara. Dr. Opara received her medical degree from Wayne State University School of Medicine (WSUSOM) and completed a med-peds residency at the Detroit Medical Center where she served as chief medical resident. Currently, she is a double-board certified and an assistant professor of internal medicine and pediatrics.
Why would someone choose to donate their body to medical education? We have a dishonorable history in medicine of illicitly sourcing cadavers for dissection: robbing corpses from graves, murdering people for their bodies and salvaging the unclaimed dead from city hospitals and morgues. Today, we call the bodies we learn from “donors” instead of “cadavers” to honor their autonomy and personhood, their choice to be in the room.
As physicians, we must work to lift patients up when they are struggling, rather than shaming them into well-being. As Dr. Donald Berwick once noted, it is not always patients’ diagnoses, but their helplessness that kills them. Indeed, the helplessness we instill through our focus on individualism and molecular pathology in the clinical setting will ensure that this epidemic kills millions prematurely and costs billions of dollars. If obesity is a disease caused by society — its inequities, trauma, and expectations — then the solution for obesity should address more than just the patient sitting in front of us.
After four years of intensive studying, two years with long hours in the hospital and three years of dating, we made the decision to apply to dermatology and plastic surgery. Recognizing the competitive nature of both of these fields, we quickly realized that matching together may not be feasible. We wanted to take each other into account in the process without either one of us making a large sacrifice in the quality of our training program to be together. Open communication and transparency were critical for us throughout the process.
It is the day before the first anatomy lab for the first-year medical students, and a single professor walks alone, up and down rows of tables laden with 26 naked, embalmed bodies. He silently shares a few minutes with the donors, a private thank-you. Soon the donors will be covered in white sheets, and the students will tentatively spill through the locked wooden doors of the labs, a rush of anticipation, teamwork, questions and learning.
Another day passed as I approached the deadline of my latest assignment. Our professor asked students rotating in the ICU to reflect and write up a patient encounter that influenced them deeply.
Columnist
Kasturba Medical College
Vinayak is a fifth-year medical student at Kasturba Medical College in India. A research stint at Johns Hopkins got him interested in medical education. He is particularly interested in clinical competencies, affective milestones and the incorporation of humanities in MedEd, on which he delivered a TEDx talk. In his free time, he enjoys sleeping, eating and being a medical student.
In the Quest for Competence
Medical education today struggles to keep pace with actual medical practice. Moving from an information-driven curriculum to a value driven one has propelled a vast array of research and scholarship in teaching methods, assessments and competencies. In this column, I hope to share insights on some of these areas as well as call for learning that is more adaptive and less standardized.
