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.
On July 27, 2020, I began the first day of orientation week at the Medical College of Georgia (MCG). After over four years of living in Atlanta, the initial 25-minute drive from home to school threw me back to my high school days of having to wake up at six o’clock in the morning. The entire first week was a bit of a blur, and I do not remember much aside from getting my stethoscope and helping draft a class oath. By the second week, the enormity of the curriculum hit me like a truck, and all the tropes I had ever heard about the difficulty of medical school immediately took effect — drinking from a fire hydrant, finals week of undergrad every week and unlimited, but undesired, pancakes.
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.
In this episode, Peter and I put together the culmination of our first season of podcasting. We took lessons from leaders in medicine, business and the military to bring you 5 rules for leadership.
When the start of M3 year came along, I was ready: ready to put my First Aid book to rest, ready to be involved with patient care, ready to observe physicians in their realm of expertise and ready to find my place in the broad field of medicine. Now, halfway through the twelve months of clerkships, I ask myself, was it all I imagined it would be as an inexperienced first-year student?
This feeling of loss and subsequent reflection revealed to me something fundamental about how I experience time in my own life. As I depart the anatomy lab, I stand on the shores of time’s river and gaze into the clear water’s surface. In it, I see a reflection of growth and of internal transformation — a reflection not of who I was but of who I have become. I emerge not only learned in anatomy but also with insight into the impact that individuals can have on one another.
On the first day of anatomy, we were reminded that this course was a once-in-a-lifetime experience and that we were privileged to be experiencing it. For those of us first-year medical students who might not pursue surgery nor experience physically interacting with and entering the human body again outside of surgical clerkships, the professors said this would be an intense time. We would peer into the spaces and structures that — on some level — make up every human being.
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.
He recently launched the Anti-Fragility Initiative, which takes a unique approach to addressing Cleveland’s teen poverty challenge and has already received over $2 million from the Governor of Ohio.
The heart monitor beeped incessantly, and the pulse oximeter kept dropping to the 80s. I ran to get a nurse. He walked calmly into the room, straightened the patient’s finger and left without a word. The oxygen went back up to 98.
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.