As she closed the door behind her, the palliative care geriatrician whom I (Meghan) was shadowing turned and said, “Remember, there are no difficult patients – just difficult situations.” We walked to our next patient, Mrs. C, who was suffering from congestive heart failure. All cures had been exhausted and she was tired of being at the hospital but was scared to enter hospice care. The doctor clasped hands with Mrs. C and explained that starting hospice did not mean giving up – it meant living life on her own terms in the time that was left. After these discussions, Mrs. C appeared more at ease and decided to pursue hospice care at her home.
Medical student, why don’t you intubate? / The OR is safe, it’ll go great.
While I maneuvered through my first block of medical school, I felt emboldened by how well my undergraduate studies and extracurriculars prepared me for the transition. With that being said, Osteopathic Manipulative Medicine (OMM) snuck in on its Trojan horse and presented me with a very unexpected challenge.
During my OB/GYN rotation, one of my primary roles as a medical student was to observe and assist during labor and delivery. On one particularly memorable Friday afternoon, after we welcomed a healthy baby boy into our world, I delivered the placenta wholly intact on my own. However, while I felt satisfied with a job well done, something was dripping down my leg…
“I’m sorry that you have to see me this way,” said Ms. A as we exited the examining room. Twenty minutes earlier, Ms. A had been laughing and cracking jokes while my attending physician and I obtained her medical history and life updates.
Most students recognize Dr. Jason Ryan as the creator of the Boards & Beyond (B&B) video series. His modules have been lauded for being concise enough to target board prep, yet comprehensive enough to strengthen a student’s understanding of (often) some very challenging content areas. While he may be well known for his video lectures, we decided to go “beyond” in this Q&A.
I took a quick trip to Target a month ago and browsed for new jeans. I approached the clothing section and was suddenly struck by the overwhelming challenge I had undertaken. From rack to rack, I had to choose from a multitude of different brands (Levis, Wrangler, True Religion and more), different styles (skinny, bootcut, tapered and more) and different colors (blue, black, tan and more). I had to figure out my current exact size and, even then, there are many different ways to size jeans (small-medium-large, waist-by-length and others).
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.
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.
Current evidence suggests that much of human health is influenced more significantly by contextual factors like the social determinants of health than the direct receipt of health care. This relatively new understanding has challenged the notion of “physicianhood” and what it means to improve the health of entire populations and communities. With the influx of issues that the pandemic has brought with it, this new model for being a highly effective physician has become even more important.
Although I’ve spent only a mere two and a half years as a student in this world of medical education, it’s readily apparent that I fit into very few of the “typical medical student” patterns. I’m part of a small cohort of dual degree students. I’m nontraditional, having never considered becoming a physician until after I graduated from college in 2013. And I am a disabled woman.
The elegant sport of tennis has evolved over numerous decades, from using wooden rackets to the graphite rackets of today. The historic grass-court stages of Wimbledon have also undergone changes as champions were crowned. Likewise, medical innovations have advanced greatly.