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.
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. In an effort to encourage a more humane and nuanced understanding of medicine, this was part of a series of reflective assignments being introduced in medical schools. While the budding writer in me was delighted at this prospect, the medical student, ironically, was …
When I was 17, I went to the gynecologist for a Pap smear because my mom said, “Once you have sex you have to get one.” It felt like punishment, but it was also the only way I had a chance of getting birth control. I went to three different doctors and exam after exam, they kept saying I could have cancer. I did a ‘colpo’ — whatever that is. After that, they did three different procedures on me, THREE, all to take pieces of my cervix. I don’t remember what they were called or what even happened. All I remember is the pain.
I entered the office of the Community Health Council of Wyandotte County, Kansas City, on a muggy, late-summer day during my family medicine rotation. The air-conditioned building boasted a large front room with sporadically placed desks, children’s books and toys, and what looked like a large food pantry. I flexed my elbows and wagged my arms to fan out the sweat from my Black body enshrouded in my white coat.
I had developed a strong friendship with Ms. D during the rotation, and her passing became one of the first confrontations with grief that I encountered as a rising medical student.
Thank you for your contributions and your readership over the past year. It has certainly been a difficult one, and we are exceedingly grateful that you all used in-Training as a platform to share your reflections, opinions, and solutions. Run by medical students and for medical students, your ongoing support is what makes us a premier online peer-reviewed publication. We look forward to seeing your contributions in 2021, and we’re excited to see where the year takes us (hopefully some place better!).
My first day in the morgue was a shock to the system — the smell of death, the sight of rigor mortis and the comfort of everyone around me with the task at hand. I thought my prior health care experience prepared me for this, but it clearly did not.
5:00 am, the first day on the night shift, / six deliveries completed and only one hour remains. / A call from the nurse says the patient in 14 is five centimeters dilated, / and so we enter the room to rupture her membranes.
The clock strikes midnight and just like that, / she’s been laboring for 10 hours as expected, / time flies when you can’t feel contraction pain.
Mercedes drove two hours to the nearest healthcare clinic to get her first physical exam in ten years. I met Mercedes while shadowing a primary care physician, Dr. L. In the clinic, Mercedes divulged to me how nervous she had been driving in – she knew what the meeting held in store. Her fears were confirmed: just five minutes into her exam, Dr. L advised her, “Mercedes, you have to lose weight.”
She was a woman in her early twenties accompanied by her husband. She was a first-time expecting mother at 19 weeks gestation with twins. They had received regular prenatal care and had been doing everything as the doctor had instructed to ensure a healthy pregnancy. She made this appointment because she felt something was off, her motherly instincts already keen.
Just a five-year-old kid / Yet always in and out of the hospital, / Since her first beautiful breath / Through each breath after, / With her life-giving / Yet ever-faltering lungs.
Patient 15 was a fit 38-year-old female with a past medical history of dilated cardiomyopathy who presented for follow-up on her most recent echocardiogram results. Flipping through the past notes, prior echos, family histories, I was captivated. A previous echo revealed an ejection fraction of about 50% — her heart was already revealing its impending fragility. The most recent echo, just five months later, revealed an ejection fraction of 20% — her heart was failing!
Contributing Writer
Florida International University Herbert Wertheim College of Medicine
Samantha is a third-year medical student at Florida International University Herbert Wertheim College of Medicine in Miami, Florida class of 2022. In 2016, she graduated from Florida International University with a Bachelor of Science in biology. She enjoys yoga, going to the beach, and reading in her free time. After graduating medical school, Samantha would like to pursue a career in Pediatrics.
