Emotional Rollercoaster: Learning to Doctor through Humbling Experiences

By Kihyun Kwon

It was an eventful start to the morning. My attending saw the first patient, who voiced murder ideation towards her unfaithful husband. I imagined myself being taken aback in a troublesome situation like that. I was still in a state of shock when my patient arrived. The clinic schedule had no regard for my emotions and gave me the most difficult patient I ever came across.

The nurse came back shaking her head and said, “The patient will not talk or make any eye contact.” The preparation notes I took earlier said she was a college student with Autism spectrum disorder, depression and anxiety. Never having had any interaction or personal experience with autism, I was nervous. My attending offered to see the patient with me, but I took the initiative to interview by myself. The patient was lying on the examination table playing on the phone while her mother greeted me. I introduced myself to the disinterested patient; I was utterly ignored.

I asked the mother about the patient’s history.

“How has she been doing?”

“Have her symptoms improved?”

Talking about the patient in her presence without actually conversing with her felt awkward. Answers that the mother gave seemed impersonal, and I could not empathize with the information especially with the patient being engaged in her phone.

I wasn’t sure if it was out of annoyance, or concern, but I started directing questions toward the patient.Read More »

Sharing at the Free Clinic

By Megan Masten

I recently had the opportunity to spend a month at a free health-care clinic in Flint, Michigan as part of my third year Internal Medicine clerkship.

I am in an underserved medicine program and I have a deep interest in working with people who have characteristically been left out of healthcare.  I loved working with the population who receive their healthcare services at the free clinic – I have mostly been impressed with patient’s willingness to feel vulnerable.  I have spent my third year of medical school in a variety of medical settings, and my favorite type of patient interactions are the ones where patients are willing to be completely honest with me and share things about their life that they might be ashamed of or have complicated feelings about.  I feel like I am doing what I’m called to do when I get to have difficult discussions with people about medical and non-medical issues that affect their lives, and my ability to have these discussions has been strengthened by my time at the clinic.

I spent time with a patient at the Free Clinic who opened up to me about his mental health issues.  He was recently started on a new antidepressant medication for depression and anxiety, and he was open and honest about his challenging feelings.  He shared with me that he was feeling really depressed and had frequent suicidal ideations – and he was quick to say, “I’m sure you don’t struggle with depression, I’m sure your life is really good.”  It was such an important and unexpected conversation to be had; although I don’t personally struggle with depression at this point in my life, I can’t say that I never will, and I can’t say that I don’t understand how he feels.  I shared this with him, and I shared with him the fact that I have family members with depression and bipolar disorder who have been suicidal in the past.Read More »

The Past Today: A Southern Physician Visits the Mississippi Civil Rights Museum

By Suzanne Minor

At this year’s Southern Group on Educational Affairs conference, the University of Mississippi hosted an outing at the Two Mississippi Museums, consisting of the Museum of Mississippi History and the Mississippi Civil Rights Museum.

I focused my visit on the Mississippi Civil Rights Museum.  It was exhausting, difficult, heart-wrenching, and, in the end, hopeful.  Growing up in rural Georgia and Jacksonville, Florida, I witnessed legalized segregation through small private schools and experienced rampant racism as the norm. Thankfully, college and medical school broadened my perspective, particularly gross anatomy.  Once without skin, all of those black and white cadavers looked so similar.  Not better than or less than, but equal in skinless death.  I dove into former slave narratives, reading Frederick Douglas and trying to reconcile the message from my upbringing – that I was better than because I was white – with my new learning in gross anatomy and in my direct experience with people who looked different than me.  I was learning that we were all just human, no better and no worse than each other.  My professional career has been dedicated to attending to the medical and holistic needs of the underserved communities of Miami, Florida, a diverse area in which I’m in the minority.

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Switching Roles: A Physician, An Educator, A Patient

By Nalini Juthani

On a bright early morning while getting ready for work, suddenly, something went “Swoosh” in my head. I saw double and felt dizzy with eyes open. Horrified, I returned back to my bed. In a few moments I began to play out various scenarios in my mind. Each potential diagnosis that flashed in front of me had an ominous outcome although my mind was clear. I woke up my husband, a physician, who examined me and said “I am calling our neurosurgeon neighbor”. It was a remarkable Friday when the world seemed to be crashing down on me.

I was a 40-year-old, happily married doctor with three loving young children. Our family had just moved into a new home. I was also enjoying a successful academic career. I wanted to live.  I was simply afraid to die!Read More »

A Reflection on The Match: Appreciating and Addressing the Financial Burden on Students

By Justin D. Triemstra

Match day.

Those two words can bring back a fountain of emotions for physicians.  For some, excitement and thrill. For others, anxiety or sorrow. But for most, a significant financial burden during a time of limited income. A recent discussion with a fourth year medical student reminded me of this important, yet under-recognized dilemma. One that can affect the geographical diversity of residency classes and increase disparities for students coming from low resource settings.

Since 1952, The Match has placed medical students into residency training programs. In 2017, 43,157 registrants entered The Match with 31,757 filled positions. To obtain a filled position, many students attend a significant number of interviews with the mean number of interviews attended at 12 for matched applications in 2017.1 Each interview adds to the financial burden for students with recent studies in Emergency Medicine reporting an estimated cost per trip to be about $350.2,3 With an average number of interviews attended at 12, we estimate an average medical student will spend $4200 during interview season; a significant burden for a non-salaried trainee and a number that is likely much higher for a significant number of applicants.

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My Classroom Is Empty: Is That a Problem?

By Kamran M. Mirza

I am no stranger to disseminating information to a group of individuals junior to me.  As a resident and fellow, I have taught many medical students in a classroom setting.  As I think back to these sessions now, I find that they were all in a setting where the student’s presence was mandatory; a review session, a laboratory etc. Nevertheless, my love for teaching grew in those sessions.  My passion for novel pedagogical approaches to pathology education led me to seek a faculty position.  I felt that there was so much I could try and achieve.  I was very excited to become pathology faculty.  What a great honor.  I couldn’t wait to meet my students.

Last fall, as I walked in to my first lecture, I found a half-empty classroom. Rows upon rows of…. no one.  Who will be the beneficiaries of my innovative theoretical pedagogy?  This was even more unusual since the lecture in question is one of the first three lectures of the M2 curriculum, typically scheduled for the first day! In the few years I have been teaching this course, I always found the entire class showing up for Day 1.Read More »

Closing the Door on the “Closing Doors” Metaphor: Reframing our Step 1 Advice

By Emily Green

Anyone who advises medical students about USMLE Step 1 will be familiar with the metaphor of “closing doors”.  Upon receiving their Step 1 score, worried students wonder if the sound they are hearing is the slamming shut of gateways to particular specialties.  The problem with the pervasive “closing doors” metaphor is that it presents career options as being either available or unavailable, with little in-between.  In a student’s mind, a score of 240 might mean that the door to a particular career is open, but a 239 means that it is closed.  Convincing students the wrongness of this thinking is a challenge.Read More »