“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.
Not sure? Uncomfortable? The popular advice is it to just “fake it until you make it.” Since starting medical school, I have heard students repeat the phrase frequently as a way to grapple with novel and occasionally unsettling situations, as well as the extensive amount of knowledge we are expected to rapidly acquire and apply.
His eyes are hidden beneath a pair of shades. I wish I could see them. A tweed cap, or as I like to think of it, a “grandfather” cap, covers his head. He leans his back against the chair with his hands resting on a cane.
Each time we came in for our Islamic Medical Association of North America (IMANA) Medical Clinic, we never knew what to expect. IMANA clinic is a community-based project led by the Albany Medical College Family Medicine Office that connects medical students to the local Muslim population through screening and education clinics at Masjid As-Salaam. This masjid is the central prayer space and community support for many of Albany’s Muslims. The unique quality of this service-learning program is its emphasis on cultural competency and understanding the role of spirituality in medical care.
During our medical training, taking a proper history and doing a thorough clinical examination within a limited time period are the two skills that we are expected to master perfectly. Our teachers tell us that a good history gives you 75 percent of your diagnosis and the clinical examination gets you 90 to 100 percent of the diagnosis.