No Smoking This Side of Room: Reflecting on things that aren’t there any more after 42 years as a student and a teacher in a medical school

By Michael Dauzvardis

In The Beginning

It was June of 1977 and I had just begun my graduate career in anatomy.  Little did I know that I would be taking all my major classes with the medical students.  A lifelong journey in accompanying medical students in various ways had begun.

The Lecture Hall

A typical day in anatomy class began with 130 or so medical students, shuffling sleepy eyed into their small seats with swing out mini desk tops. They came bearing newspapers, coffee mugs, 3 course breakfasts, adorned in hair too long and shorts too short.  Bell bottoms, blue jeans, and baseball caps ruled the day.  I quickly assimilated by wearing my new Levi overalls. On the right side of the room (while facing the podium) was a sign affixed to the wall which declared “No Smoking This Side of Room.”  Now I must say that on the opposite side of the room I did not observe a lot of smoking but on more than one occasion I observed a student chewing tobacco and spitting into a large plastic cup during lecture.  The class of 122 consisted of 90 men, and 32 women– with a racial and ethnic composition of 1 black person, 3 Latinos, 7 Asian-Americans, and 111 Caucasians.  Forty-six of the men had mustaches, with the majority of those also sporting beards.  It was the prime of the disco period and it showed.

A portion of a newspaper containing the daily crossword puzzle would be passed around for each student to contribute. The instructors drew on a thing called a chalk board while some students tried to keep up on their yellow pads of legal paper. Audiovisuals consisted of carousels of 35 mm slides projected onto a pull down screen in the front of the room. On more than one occasion I observed a professor drop his entire tray of slides before lecture.  The slides would fly in all directions. Students and staff, eager to be helpful, would assist in reloading the carousel, but since slides needed to be placed upside down and reversed in order to be projected correctly, this usually resulted in much confusion and sore necks during the lecture.  These slide carousals also provided for the mischievous opportunity of inserting bogus slides into the lecture.  If a lecturer wanted to show a “film strip” he had to notify the AV department in advance so they could bring in a reel-to-reel projector, whose sound never worked and which often melted the film.

There were no computers or cell phones (two payphones were mounted outside the lecture halls).  Pocket calculators were the rage–and I even saw an occasional slide rule.  Virtually all students participated for 15 dollars in a co-op note club.  Each student would be assigned a lecture at which he or she would take detailed notes.  These were typed out, mimeographed and distributed to the entire class.

The lecture hall had a center aisle, but no side aisle.  As a result, students had to climb over each other to get to and from the end seats.  Furthermore, the floor slanted at almost 45 degrees toward the front such that a dropped pencil or spilled cup of coffee made it all the way down to the lecturer.  The lecture hall spanned two floors with the upper half flanked by the outer windows in a manner leaving a precarious eight-foot drop hidden by curtains– which on more than one occasion gobbled up a medical student like a bug in a Venus flytrap.

The Pub

There was a long, often leaky, run-down hallway that connected the medical school and hospital with the dental school, a dark tiny basketball court, an old theater, and the beloved pub. The pub served pizza and sandwiches and soft drinks for lunch during the week.  But, at 2:55 pm on Fridays, students, staff, and faculty could be seen with their tongues attached to the outside of the pub 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.

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 »

Extension

By Tim Lahey

Every March I run the last required course at our medical school. It’s a three-week-long, 47-hour sprint – a sort of boot camp for professional formation. We polish clinical skills, revisit foundational sciences, let students pick from a menu of interesting tutorials, and discuss professional formation.

Students grapple with hypothetical gastrointestinal crises on scatalogically-named student teams. They resuscitate rubbery patients with various flavors of hypotension. I don a sparkly red bowtie to MC a game show called Antibiotic Jeopardy.

Throughout, we discuss the evolution of their professional identities. I ask how their idealism has changed during medical school, and every year over 60% say it has waned. We share the stories that shape us, and how they can stay true to the values that brought them to medical school in the first place. Then they hand in a tall stack of confidential essays that I reply to on nights and weekends right up until the day they speak the Hippocratic Oath. Read More »

Going the Extra Mile: A Med Student’s Marathon

By Shoshana B. Weiner

“4 ounces water every mile, half an electrolyte ‘gu’ pack over 2.5 miles, ¼ energy bar every 6 miles.”  AKA how did you manage training for a marathon while in medical school?  The simple truth: I decided to run a marathon so I did.  Longer story: months of rigorous training, more moments of doubt than I care to recall, and insights already positively impacting my medical training.

Training for and running a marathon is a time-intensive commitment of physical and mental endurance.  Age-old lessons of “you can accomplish anything you set your mind to; hard work pays off” hold true and gained new meaning for me. Read More »

Overcoming Uncertainty through Experience

By Michelle Sergi

Coming out of my first year of medical school I struggled with my sense of confidence.  After endless nights of studying, a multitude of experiences at our Clinical Training and Assessment Center, and specialized clinical experiences, I felt that I could take on the challenge of counseling patients.  On the other hand, when I thought about being on my own to take care of patients, I was terrified.  My pharmacology knowledge was insufficient, and even though I knew how to conduct a full physical exam, did I really know what was normal compared to abnormal?  These questions proved to me that I lacked the clinical experience necessary to become a good physician.

When I heard of the opportunity to apply for the Leroy Rogers Preceptorship, I immediately knew that it could help bridge the gap between my medical textbooks and clinical knowledge.  This program gives preclinical students the opportunity to choose a preceptor for a four week, hands-on family medicine clinical experience.  I had shadowed a family physician, Dr. Andrews, in my hometown several times before so I knew he would be the perfect preceptor.  I also felt that I would learn from his patients, especially because many are medically underserved.Read More »

New Year’s Resolutions – Walking the Talk with Compassion

By Hedy S. Wald

Take two Tootsie Rolls and call me in the morning. Self-prescribed for sweet tooth me. Not such a blasphemous “drug of choice” (I’m not even using caffeine!) but it’s New Year’s, that infamous time of resolutions. And I’d like to “kick the habit,” do all that stuff the nutritionist advised and ramp up the gym visits. Jogged 2 miles and took a 1/2 mile swim today to start the new year “right” – hopefully burned off the chocolate high. Fueled by endorphins and feeling oh so optimistic, I’m writing this blog. The question is – what happens on January 2?

The ongoing effort to implement and sustain behavior change has given me a profound appreciation for some of the struggles our patients (and even our colleagues and students) endure. Harnessing motivation can be tough and self-flagellation for not following through can make it tougher . . .  this is where some self-compassion with an attitude of kindness and acceptance toward ourselves may make a difference (1). Self-compassion can promote self-improvement motivation given that it encourages us to confront mistakes or weaknesses without either self-deprecation or defensive self-enhancement. (2) According to Breines and Chen, “resolving to make changes can be scary, as roadblocks and setbacks are inevitable along the way. From a self-compassionate perspective, however, there is less to fear.” (2)

Read More »