Trainee Perspective – AM Rounds http://academicmedicineblog.org Beyond the pages of Academic Medicine, journal of the AAMC Thu, 17 Aug 2017 20:05:42 +0000 en-US hourly 1 https://wordpress.org/?v=4.4.10 Author Reading: From Reflex to Reflection: A Resident’s Perspective on Learning in a Clinical Setting http://academicmedicineblog.org/author-reading-from-reflex-to-reflection-a-residents-perspective-on-learning-in-a-clinical-setting/ Tue, 11 Jul 2017 19:00:27 +0000 http://academicmedicineblog.org/?p=3463 A new episode of our podcast is now available through iTunes. Listen today.

In this episode, Veena Patel reads her essay, “From Reflex to Reflection: A Resident’s Perspective on Learning in a Clinical Setting,” in which she reflects on a patient encounter that motivated her to be a proponent of change and improvement at her hospital. Her essay was published in the Teaching and Learning Moments column in the July issue of Academic Medicine.

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The Unstoppables: Undocumented Students in Medical Education http://academicmedicineblog.org/the-unstoppables-undocumented-students-in-medical-education/ http://academicmedicineblog.org/the-unstoppables-undocumented-students-in-medical-education/#comments Tue, 27 Jun 2017 11:00:09 +0000 http://academicmedicineblog.org/?p=3437 hands in go team formation

By: Raquel Rodriguez

R. Rodriguez is a first-year family medicine resident, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California.

At eight years old, my first glimpse of the United States was the arid land that separates the U.S.-Mexico border. As I sat in the car waiting to be assessed by the uniformed border patrol guards—marveling at the barren land of opportunity—I could not have imagined how crossing this border would transform my life. My new, secretive existence would make the simplest tasks into unusual challenges. As an undocumented student, turning sixteen came without a driver’s license, turning eighteen came with no reassurance that I would be able to attend college, and my first trip home as an undergraduate was plagued with anxiety as I handed my student ID to airport security. Fearing deportation, I guarded my secret and focused on my education.

In recent years, not unlike me, many undocumented students throughout the country have found themselves without clear hope for the future. Their ineligibility for employment having hindered their efforts to pursue a medical career. Despite their unrelenting persistence, their achievements in the classroom, and the support of entire communities, the dream of attending medical school seemed out of reach. I met many of these hopeful students as I searched for one who had successfully matriculated into a medical training program. I found none. Nonetheless, their stories of resilience amazed me and provided me with the motivation to investigate further.

Counter to the advice of premedical advisers, I applied to medical school. At the time, their concerns were valid and quite serious: How will you pay for medical school when your immigration status makes you ineligible for federal loans? What will you do after graduation without employment eligibility?

A medical program took a chance on my application, and I began my studies in the fall of 2011. As expected, financial challenges persisted, but a significant reprieve arrived shortly before my third-year clerkships. The Deferred Action for Childhood Arrivals (DACA) program was implemented. Via this federal memorandum, I was finally allowed to obtain employment authorization, a driver’s license, and an identity of belonging in the United States—benefits that had eluded me since my arrival in this country almost twenty years ago.

Since the DACA program was established, many medical schools have officially opened their doors to DACA recipients. While these talented students currently make up a small percentage of medical students, their stories have impressed me with their resilience, creativity, and humility—traits that everyone would value in their own physician. As described in the article, “Considerations for Residency Programs Regarding Accepting Undocumented Students Who Are DACA Recipients,” the next step is to facilitate their continued medical training.

On the days when my commute to the hospital provides me with time for reflection, I think about the undocumented students I have met and how my achievements are inspired by their stories. These students have given me hope. Now, I can only dream that the communities they call home will give them the precious opportunity to see an America that is not arid, but one that has tall buildings, resplendent streets, and where their dreams will know no boundaries.

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Author Reading: Humbled http://academicmedicineblog.org/author-reading-humbled/ Thu, 22 Jun 2017 09:40:49 +0000 http://academicmedicineblog.org/?p=3446 A new episode of our podcast is now available through iTunes. Listen today.

In this episode, J.S. Desai reads his essay, “Humbled,” in which he reflects on what his first patient, his big brother, has taught him about knowing and judging others in his care. His essay was published in the Teaching and Learning Moments column in the June issue of Academic Medicine.

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Author Reading: Nutella http://academicmedicineblog.org/author-reading-nutella/ Thu, 08 Jun 2017 07:17:14 +0000 http://academicmedicineblog.org/?p=3431 A new episode of our podcast is now available through iTunes. Listen today.

In this episode, Dr. Sarah Bernstein reads her essay, “Nutella,” in which she reflects on a patient who taught her that being a doctor sometimes means sharing a spoonful of Nutella and bearing witness to a patient’s journey rather than ordering tests and medications. Her essay was published in the Teaching and Learning Moments column in the June issue of Academic Medicine.

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Author Reading: The Modern Iteration of the House Call http://academicmedicineblog.org/author-reading-the-modern-iteration-of-the-house-call/ Thu, 04 May 2017 17:08:47 +0000 http://academicmedicineblog.org/?p=3381 A new episode of our podcast is now available through iTunes. Listen today.

In this episode, Brian Kwan reads his essay, “The Modern Iteration of the House Call,” in which he describes the value of making house calls to patients, caregivers, and physicians. His essay was published in the Teaching and Learning Moments column in the May issue of Academic Medicine.

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Author Reading: Her Story of Present Illness http://academicmedicineblog.org/author-reading-her-story-of-present-illness/ Thu, 20 Apr 2017 11:07:08 +0000 http://academicmedicineblog.org/?p=3363 A new episode of our podcast is now available through iTunes. Listen today.

In this episode, medical student Jessica Prescott reads her essay, “Her Story of Present Illness,” about encouraging women to be the protagonists in their own stories. Her essay was published in the Teaching and Learning Moments column.

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Engaging “Youthful Critics”: The Learner Voice in Medical Education Scholarship http://academicmedicineblog.org/engaging-useful-critics-the-learner-voice-in-medical-education-scholarship/ Tue, 11 Apr 2017 07:11:51 +0000 http://academicmedicineblog.org/?p=3345 A new episode of our podcast is now available through iTunes. Listen and download it today.

Discussing the importance of engaging medical students and residents in medical education scholarship are editor-in-chief David Sklar and medical students Jesse Burk-Rafel, Logan Jones, and Janice Farlow.

This conversation complements trainee-authored letters to the editor and related articles in the April 2017 issue of the journal.

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Author Reading: Learning Professionalism Under Stress http://academicmedicineblog.org/author-reading-learning-professionalism-under-stress/ Tue, 28 Mar 2017 10:13:35 +0000 http://academicmedicineblog.org/?p=3338 A new episode of our podcast is now available through iTunes. Listen today.

In this episode, medical student Ben Chin-Yee reads his essay, “Learning Professionalism Under Stress,” published in the Teaching and Learning Moments column.

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Author Reading: Cold Feet http://academicmedicineblog.org/author-reading-cold-feet/ Wed, 22 Feb 2017 09:09:48 +0000 http://academicmedicineblog.org/?p=3303 A new episode of our podcast is now available through iTunes. Listen today.

In this episode, medical student Elena Grill reads her essay, “Cold Feet,” published in the Teaching and Learning Moments column.

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Getting an Early Start: Developing the MD-MEd Program at Vanderbilt University http://academicmedicineblog.org/getting-an-early-start-developing-the-md-med-program-at-vanderbilt-university/ Thu, 16 Feb 2017 06:00:42 +0000 http://academicmedicineblog.org/?p=3295 AM Rounds Slider Master-10

By: William Sullivan, MD, MEd

William Sullivan, MD, MEd is a fourth-year resident in internal medicine and pediatrics at Vanderbilt University Medical Center. He is the first Vanderbilt Medical School graduate to earn both the MD and MEd degrees jointly. He will be chief resident in internal medicine during the 2018–2019 academic year.

When I was a third-year medical student at the VA hospital in Nashville, an attending physician posed a simple question that fueled my desire to delve deeper into medical education. “How do you think about acute kidney injury?” he asked, after silently listening to my presentation. I was speechless, because I could not find the answer in any medical record or textbook. Thankfully, by modeling his own thought process, I was able to conceptualize a framework for this metacognitive skill. We worked together to develop this skill over the next two weeks, which sparked a craving in me to understand reasoning, how people learn to reason, and how to teach reasoning. It ultimately led me to facilitate the creation of the joint MD and Master’s in Education (MEd) degree at Vanderbilt University, described in a recent Academic Medicine article.

When I started this journey in 2011, I was fortunate to have the Peabody College of Education, a national leader in educational research and training, literally right across the street. At the time, I had peers taking time off from medical school to complete MPH degrees, MBA degrees, and research fellowships. So, why couldn’t I pursue my interest and seek additional graduate training in education? As it turns out, I could! It just hadn’t been done before. Working in concert with the Dean for Undergraduate Medical education at the Vanderbilt University School of Medicine (VUSM) as well as the faculty director of the Program of Learning and Instruction at Peabody College, I modeled the five-year program after five-year programs already established at Vanderbilt (e.g., MD-MBA, MD-MPH) as well as joint MD degree programs at other institutions, already published in the literature.

Initially, I had some logistical kinks to work out, and I learned that each school’s registrar was going to be an integral part of making this new program work. In communicating regularly with the registrars, I was able to ensure that credits would be transferred appropriately and that the tuition I would pay each semester was accurate and went to the right place! Patience, open communication, and administrative support have allowed the program to grow. Four other students have since enrolled or graduated, and we are working to craft developmentally appropriate medical education competencies for program participants.

Medical students and residents who take additional time to pursue training in experimental design, business, public health, and statistics enter their professional careers primed to contribute to their institution and profession in an area they are passionate about. I wanted to incorporate the skill set of an educator early in my career so that I could become a better teacher (like the faculty member who inspired me), understand concepts in medical education, and influence the field on a larger scale.

As I finish my residency, my educational training through the MEd program has already proven valuable. I now have a variety of unique, critical lenses through which to view teaching and learning encounters with students, peers, and patients. When students and interns ask me questions, I’m not likely to give them a direct answer. Rather, I ask them what they know, how they are thinking, and provide scaffolding so they can reach their own conclusions. I give better feedback and ask better questions. Faculty have asked for my input when thinking about designing educational materials. Recently, I met with my program director to discuss ideas for a “training the trainer” feedback event hosted by Graduate Medical Education at Vanderbilt. Also, because of my learned skill set on how to be a thoughtful educator, I will have the amazing and humbling honor to be a chief resident one year from now.

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