Match Day Spotlight 2016: Pathology, Round 2
Diane Brackett, a recent fourth-year medical student who matched to Massachusetts General Hospital for pathology, gives us her expert advice on succeeding in medical school and beyond.
Diane Brackett, a recent fourth-year medical student who matched to Massachusetts General Hospital for pathology, gives us her expert advice on succeeding in medical school and beyond.
Samantha Margulies, a recent fourth-year medical student who matched to Yale-New Haven Hospital for obstetrics and gynecology, gives us her expert advice on succeeding in medical school and beyond.
A very important topic is that of mental health in medical practitioners, notably medical students. According to a study in the Student British Medical Journal, 30% of medical students report having a mental health condition — with a majority of 80% stating the level of available support was poor or only moderately adequate. This column was born from these alarming statistics and aims to stimulate conversation on mental health in medical students, from providing suggestions on how to maintain one’s mental health to discussing the taboo and stigma surrounding conversations on mental health in practitioners and students, and how to eliminate it.
At Albany Medical College, upon our orientation to gross anatomy, we are asked to draw our feelings on blank index cards prior to entering the cadaver laboratory. As we progress through the year, our sentiments regarding anatomy may remain the same, or may change, and these drawings allow us to look back at this milestone we crossed as budding medical students.
During our many years of medical training, we study complex physiological processes running the gamut from acute sepsis to the equally devastating progression of chronic diseases. We spend countless hours in lectures and on the wards, attempting to gain exposure to proper medical management of bread-and-butter medical problems as well as more obscure diseases which may only affect a handful of patients annually. However, most medical schools neglect to teach one crucial area of expertise — training in advocacy skills to address social determinants of health.
Gun violence is a public health crisis. On your average day in America, 297 people are victims of gun violence. They are shot in murders, assaults, suicide attempts and completions and police interventions. 89 of these victims died — seven of which were children. In the first 90 days of 2016, there have been 57 mass shootings. Your average American is now equally as likely to die via firearms as in a car crash.
I recently finished reading Tracy Kidder’s Strength in What Remains, which highlights one man’s journey from the genocide in Burundi and Rwanda to becoming a refugee in New York City. Some chapters are quite graphic in their descriptions of the slaughtering of Hutus and Tutsis — the pain, suffering and atrocities he witnessed. These deaths seemed nothing like being on a morphine drip in an ICU bed or falling into a final deep sleep as your family surrounds you with tears and prayers. Instead they seemed gruesome and inhumane.
Medical students’ place in the hierarchy of medicine means we are routinely restricted in what we can (or should) say. That taboo list includes our own transformation — despite being only one of thousands impacted by medical education, all too often we are left alone to process how it changes us. Review of Systems is a series of down-to-earth slam poems by Kate Bock, putting words to the unspoken process not just of learning medicine, but of becoming a doctor.
I went through medical school without experiencing the death of a patient I had personally cared for. In contrast to what may be seen on the trauma service, my surgery clerkship was full of routine procedures: appendectomies and cholecystectomies, port placements, excisions of pilonidal cysts, and miscellaneous “ditzels,” as pathologists may refer to them as. Sure, I have had patients who were quite sick and did not have much time left to live. For example, I once performed a neurologic exam on a comatose teenager in the ICU, whose arteriovenous malformation had bled wildly out of control despite prior neurosurgery. But with the constant shuffling of rotations that medical students must endure, I was always in and out of patients’ lives before they had a chance to leave mine.
Too often medical students lose their motivation because of emotional exhaustion, depersonalization and a diminished sense of personal accomplishment. Medical students should no longer see their education as a challenge to overcome. They should see it as a game that can be won.
“This is a place where the dead are pleased to help the living.”
These words always greet me upon entering our anatomy lab. A similar saying in Latin is inscribed at the Palazzo del Bo at the University of Padua, home of the world’s oldest anatomical theater.
As medical students, we recognize that bias in medicine is doubly damaging: it burdens our peers and it harms our patients. In the opening narratives we see both of these at play: in Micaela’s self-doubt and frustration, and in the intern’s judgment of their older, Latina patient. Such clinician bias has been increasingly shown to contribute to widespread health inequities.