Categories
Clinical Community Service Emotion Empathy General Healthcare Disparities Opinion Public Health

Let Me Be Brief: Community Leadership

A series of briefs by Texas Medical Students

By: Fareen Momin, Sereena Jivraj, and Melissa Huddleston

In the ever-evolving field of medicine, it is no surprise that the idea of leadership in medicine has changed over the years. Some physicians have engaged in additional leadership in the context of politics. In fact, several physicians signed the Declaration of Independence.1 Today, physician community leadership extends much further. Physicians can engage with their communities and beyond via virtual platforms. Physician “influencers” use social media to provide quick answers to patients, and physician-patient interactions on Twitter alone have increased 93% since the onset of the COVID-19 pandemic.2 With physician voices reaching ever-larger audiences, we must consider the benefits and ramifications of expanding our roles as community leaders.

Medicine and politics, once considered incompatible, are now connected.3 There is a long list of physician-politicians, and community members often encourage physicians to run for political office, as in the case of surgeon and former representative Tom Price.4 Physicians are distinctly equipped to provide insight and serve as advocates for their communities.5 Seeking to leverage this position, a political action committee (PAC), Doctors in Politics, has an ambitious desire to send 50 physicians to Congress in 2022, so they can advocate for security of coverage and freedom for patients to choose their doctor.6-7 There are dangers, however, when physicians take on this additional leadership role. For example, Senator Rand Paul (R-Ky.), an ophthalmologist, has spread medical misinformation, telling those who have had COVID-19 to “throw away their masks, go to restaurants, and live again because these people are now immune.”8

It is not practical for even those medical students who meet age requirements to run for office. What we can do is use our collective voice to hold our leaders accountable, especially when they represent our profession. We can create petitions to censure physicians who have caused harm and can serve as whistleblowers when we find evidence of wrong-doing perpetrated by healthcare professionals. We can also start engaging in patient advocacy and policy-shaping with the American Medical Association (AMA) Medical Student Section and professional organizations related to our specialty interest(s).

To avoid adding to confusion, statements by physicians should always be grounded in evidence. Dr. Fauci’s leadership is exemplary in this regard. He has worked alongside seven presidents, led the National Institute of Allergy and Infectious Diseases (NIAID) since 1984, and has become a well-known figure due to his role in guiding the nation with evidence-based research concerning the COVID-19 pandemic.9 Similarly, Dr. John Whyte, CMO for WebMD, has collaborated with the Food and Drug Administration (FDA) to advocate for safe use of medication and to educate those with vaccine apprehension.10 Following these examples, we should strive to collaborate with public health leaders and other healthcare practitioners and to advance health, wellness, and social outcomes and, in this way, have a lasting impact as leaders in the community.


  1. Goldstein Strong Medicine: Doctors Who Signed the Declaration of Independence. Cunningham Group. Published July 7, 2008. Accessed February 2, 2021. https://www.cunninghamgroupins.com/strong-medicine-doctors-who-signed-the-declaration-of-independence/
  2. Patient Engagement with Physicians on Twitter Doubles During BusinessWire. Published December 17, 2020. Accessed February 2, 2021. https://www.businesswire.com/news/home/20201217005306/en/Patient-Engagement-with-Physicians-on-Twitter- Doubles-During-Pandemic
  3. WHALEN THE DOCTOR AS A POLITICIAN. JAMA. 1899;XXXII(14):756–759. doi:10.1001/jama.1899.92450410016002d
  4. Stanley From Physician to Legislator: The Long History of Doctors in Politics. The Rotation. Published May 15, Accessed February 2, 2021. https://the-rotation.com/from-physician-to-legislator-the-long-history-of-doctors-in-politics/
  5. Carsen S, Xia The physician as leader. Mcgill J Med. 2006;9(1):1-2.
  6. Doctors in Politics Launches Ambitious Effort to Send 50 Physicians to Congress In 2022. BusinessWire. Published May 27, 2020. Accessed February 2, 2021. https://www.businesswire.com/news/home/20200527005230/en/Doctors-in-Politics-Launches-Ambitious-Effort-to- Send-50-Physicians-to-Congress-In-2022
  7. Doctors in Accessed February 2, 2021. https://doctorsinpolitics.org/whoweare
  8. Gstalter Rand Paul says COVID-19 survivors should “throw away their masks, go to restaurants, live again.” TheHill. Published November 13, 2020. Accessed February 2, 2021. https://thehill.com/homenews/senate/525819-rand-paul-says-covid-19-survivors-should-throw-away-their-masks-go-to
  9. Anthony Fauci, M.D. | NIH: National Institute of Allergy and Infectious Diseases. Published January 20, 2021. Accessed February 2, 2021. https://www.niaid.nih.gov/about/anthony-s-fauci-md-bio
  10. Parks Physicians in government: The FDA and public health. American Medical Association. Published June 29, 2016. Accessed February 2, 2021. https://www.ama-assn.org/residents-students/transition-practice/physicians-government-fda-and-public-health
Categories
Clinical Emotion Empathy General Humanistic Psychology Opinion

Let Me Be Brief: A Proposal to Refrain From Eating Our Young

A series of briefs by the Texas Medical Students

By: Elleana Majdinasab and Rishi Gonuguntla

Medicine has its unspoken mores, does it not? Certain specialties are notorious for their personalities, and the idea of foregoing food and sleep are deemed signs of strength and resilience. Upperclassmen advise against getting in Dr. X’s way, lest you become subject to a tailored diatribe, and you hear whispers of Dr. Y’s career-crushing evaluations. Your roommates do not bat an eye over your tears every  evening, because chances are they are no stranger to such days themselves. It doesn’t require a detective to identify that the above are the direct result of mistreatment in medical school.

Per the AAMC, mistreatment occurs when there is a show of disrespect for another person that unreasonably affects the learning process. Public humiliation and belittlement by doctors are the most common forms of mistreatment in medical school.1 The practice of aggressive “pimping,” or the act of doctors disparaging students for not knowing information, potentially in front of patients or fellow classmates, is a phenomenon too many medical students needlessly experience.2 Other examples of mistreatment include the shaming of students for asking questions and being subjected to offensive names and remarks.1 According to one 2014 study, over three-fourths of third year medical students reported being mistreated by residents, with over 10% of those responses citing recurrent mistreatment.2

Given the omnipresence of these events, one may consider whether there exists a common denominator among guilty attending physicians. Indeed, mistreatment of medical students can  occur secondary to a multitude of reasons. Physician burnout is still rampant as ever, and ironically, often occurs partly due to the same toxic culture attendings themselves experienced as budding residents.3 The doctors in question blissfully perpetuate the cycle, humiliating and pimping, justifying  their behavior with the mentality of, “I went through it back then and turned out just fine.” Thus, the vicious cycle continues. What doesn’t kill you makes you stronger, right?

As medical students, we are quietly told by the older and wiser to improve our resilience – to grow tougher skin. We are advised to expect, or even welcome, microaggressions and impatience from our superiors while we work toward our lifelong dreams.4 We take deep breaths and smile through the jabs because we are fully aware of the consequences of speaking out against the deeply ingrained practice of mistreatment.4 Mistreatment in medical school matters because doctors eating their young further propagates the toxic reputation of the career’s culture while contributing to the development of many future doctors’ unhappiness.3 It is the accumulation of years of pressure, competition, and negative experiences that leads to feelings of burnout in students and physicians alike.5 Even worse, medical students act on these feelings, and they are three times more likely to commit suicide than their similar-aged peers in other educational settings in the general population.6 The hazing of medical students is in no way constructive or beneficial to anybody involved. Stress and toxicity in the learning environment prevents students from being themselves and asking questions, thus damaging their confidence during the formative years of their training.7

Even more alarming is that mistreatment is more commonly directed towards minority students, including female, underrepresented in medicine, Asian, multiracial, and LGBTQ+ students, than it is toward their white, cis-gendered, heterosexual, male counterparts.8 In the same vein that we encourage and recruit people   from minority communities to join medicine, we must be aware of the potential mistreatment they will experience and take clear, targeted steps to protect them. If we, as a community, fail at this task, then we are complicit in perpetuating the systemic inequities and inequalities that are currently prevalent in medicine.

The reality is that the culture of medicine doesn’t have to be this way. It is certain that mistreatment has been inadvertently ingrained within the culture of medical training, so attempting to address this problem feels daunting. There is a current lack of literature regarding what interventions successfully reduce mistreatment, but introspective analysis yields some steps we may take in an attempt to slowly chip away at the current social infrastructure.9

First and foremost, students must realize and acknowledge the negativity they have been subjected to is not ‘all in their head,’ but instead a universal and rather unfounded experience. The next step is to seek support from classmates, friendly administration, and trusted professors and physicians who can provide guidance and vouch for students’ justice. Addressing mistreatment is at its core a collaborative effort, as we cannot expect only the bravest, most outspoken students to carry this initiative to fruition. Each and every person in medicine can enjoy a role and responsibility in this endeavor. School administrations can create interventions aimed at educating faculty and students about recognizing mistreatment and the harmful effects that public humiliation can have on student learning.10 It is only when students recognize abuse and have a strong support system that they may finally gain the confidence required to be vocal against toxic behavior and speak out for both themselves and classmates. Schools can further assist efforts by ensuring students are aware of their rights in this context, and offering guaranteed protection if mistreatment does rear its head.11 Current physicians may also positively contribute by gently and constructively pointing out questionable behavior among their colleagues to create a more effective learning environment. Finally, our generation of medical students is tenacious, progressive, and outspoken. We can weaken, and even break the cycle, by remembering our roots, exercising our rights, and manifesting the golden rule: to always treat others the way you want to be treated.

  1. 2020 GQ All Schools pdf. (n.d.).
  2. Cook, F., Arora, V. M., Rasinski, K. A., Curlin, F. A., & Yoon, J. D. (2014). The Prevalence of Medical Student Mistreatment and Its Association with Burnout. Academic Medicine : Journal of the Association of American Medical Colleges, 89(5), 749–754. https://doi.org/10.1097/ACM.0000000000000204
  3. Major, (2014). To Bully and Be Bullied: Harassment and Mistreatment in Medical Education. AMA Journal of Ethics, 16(3), 155–160. https://doi.org/10.1001/virtualmentor.2014.16.3.fred1-1403
  4. Assessment of the Prevalence of Medical Student Mistreatment by Sex, Race/Ethnicity, and Sexual Orientation | Medical Education and Training | JAMA Internal Medicine | JAMA Network. (n.d.). Retrieved March 16, 2021, from https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2761274?guestAccessKe y=5b371de5-4978-4643-b125-f26972348616&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=022420
  5. Dyrbye, N., Thomas, M. R., Massie, F. S., Power, D. V., Eacker, A., Harper, W., Durning, S., Moutier, C., Szydlo, D. W., Novotny, P. J., Sloan, J. A., & Shanafelt, T. D. (2008). Burnout and suicidal ideation among U.S. medical students. Annals of Internal Medicine, 149(5), 334–341. https://doi.org/10.7326/0003-4819-149-5-200809020-00008
  6. Markman, D., Soeprono, T. M., Combs, H. L., & Cosgrove, E. M. (2019). Medical student mistreatment: Understanding ‘public humiliation.’ Medical Education Online, 24(1), 1615367. https://doi.org/10.1080/10872981.2019.1615367
  7. Full article: Exploring medical students’ barriers to reporting mistreatment during clerkships: A qualitative study. (n.d.). Retrieved March 16, 2021, from https://www.tandfonline.com/doi/full/10.1080/10872981.2018.1478170
  8. Hasty, N., Br, M. E., ford, Lau, M. J. N., MD, & MHPE. (n.d.). It’s Time to Address Student Mistreatment. American College of Surgeons. Retrieved March 16, 2021, from https://www.facs.org/Education/Division-of-Education/Publications/RISE/articles/student- mistreatment
  9. Markman, D., Soeprono, T. M., Combs, H. L., & Cosgrove, E. M. (2019). Medical student mistreatment: Understanding ‘public humiliation.’ Medical Education Online, 24(1), 1615367. https://doi.org/10.1080/10872981.2019.1615367
  10. Stone, J. P., Charette, J. H., McPhalen, D. F., & Temple-Oberle, C. (2015). Under the Knife: Medical Student Perceptions of Intimidation and Journal of Surgical Education, 72(4), 749–753. https://doi.org/10.1016/j.jsurg.2015.02.003
  11. Mazer, M., Bereknyei Merrell, S., Hasty, B. N., Stave, C., & Lau, J. N. (2018). Assessment of Programs Aimed to Decrease or Prevent Mistreatment of Medical Trainees. JAMA Network Open, 1(3), e180870–e180870. https://doi.org/10.1001/jamanetworkopen.2018.0870

 

Categories
General Technology

Trending Factors That Will Revolutionize The Future Of Education

The future of education will play a key role in the future of the world as we know it. What learners are taught and how they are taught will help them assimilate into society after school. Over the years, education has changed in different ways but it is going to keep changing with time. Right now, one of the key factors that will shape the future of education is technology. Contrary to popular opinion, technology isn’t the only factor that will revolutionize education. Many other factors are already trending in today’s education industry. Some of them are listed below:

1. Project-based Learning 

This learning method allows students to gain knowledge by participating in real-world projects. The projects could either be assigned to groups or individuals and teachers check their progress over time. Depending on the complexity of the project, the timeline could be days, weeks, or the entire semester. The goal is to keep the students engaged and teach them meaningful life skills. It allows students to tap into their creativity, collaboration, and communication skills, among others

2. Video-based Learning 

Video-based learning is a popular teaching approach in learning and cognition that relies on videos in the designation of knowledge. However, it is now becoming a more mainstream method of teaching that uses visual and auditory cues. While the videos are the primary source of information, audio is used for elaboration. Video-based learning is more effective when classes are divided into short videos rather than incredibly long sections. 

3. Tech-based Learning 

Tech-based learning is a combination of different electronic technologies like audio, satellite broadcasts, intranets, webcasts, video conferencing, CD-ROM, and the Internet in general. In this Covid-19 era, tech-based learning became even more popular. Students could not attend in-person classes during the lockdown. So, they had to rely on technology to get the education they need. Older students have also been taking online tech courses on Bootcamprankings.com and Computersciencehero.com

4. Teaching Data Interpretation 

As technology advances, the manual aspects of literacy become less relevant. Students will still be taught the three major literacy courses but they will focus more on data interpretation. Computers will be handling every form of mathematical and statistical data analysis but humans will still be needed to interpret this data. Students are now being taught how to predict trends from the data they interpret. They are taught how to apply numbers to theoretical knowledge but they also need human reasoning. 

5. Diversification of Interests 

When you ask children below age 10 what they want to do with their lives, they typically pick any one of the most popular occupations. One would say he wants to be a doctor, another wants to be a lawyer, and one wants to be a nurse. Even if some of these children change their minds when they become more mature learners, some hold on to their early dreams for too long and it shapes their career path. In the future, teachers will promote the diversification of interests among students. They will consciously and unconsciously shape the future career of their students allowing them to develop interests in other fields. 

6. Real-world Skill Training 

In the future, schools will focus less on theories and more on real-world skill training. Proponents of this form of education believe that it is a more efficient method of teaching and it prepares learners for life after school. Since the beginning of the Covid-19 pandemic, many schools have had difficulty providing in-person practicals for their students to experience real-world training. Some of these schools have turned to virtual reality for a solution to their problems. Using virtual reality allows students to immerse themselves in the virtual world in a more realistic way than any other technology. It might not be the same as face to face skills training but it’s the next best thing. 

Bottomline 

The future of education will be shaped by several factors but the ones listed above will have the most significant impact. All these variables have a few things in common. First of all, they are all directed toward making the learning process more engaging. The more engaged students are, the more attentive they will be in the classroom. This will aid in the retention of knowledge as well.

Categories
General Global Health

How Has Covid-19 Disrupted Education?

Covid-19 completely changed the education sector. It made all institutions undergo an abrupt transition from in-person to online modalities. Most governments implemented lockdown from one day to another, and the sector had to come up with a solution fast. Even now, eight months later, things haven’t gone back to normal. Here is how the virus has disrupted the education industry. The stats on this article are from the OECD’s The Impact of Covid-19 on Education.

Small Budgets

The Covid-19 pandemic has increased the demand for the healthcare sector. The industry is already at its full capacity in most countries in a normal situation. But with the virus, the massive amount of new cases and people that needed medical attention reached numbers higher than ever before.

To try and meet the needs of citizens, governments started giving more funding to the healthcare sector, and the education industry was given less priority. So now, the education sector is in need of more tools like online platforms, computers, and digital devices so students can learn from home. The sector needs to prepare for when they reopen again with all safety measures like cleaning, temperature readers, face masks, and so on.

But it is a real possibility that education will have the same or a smaller budget than before the pandemic. Eleven percent of global public expenditure was directed to education on average worldwide. We will have to wait and see what happens next year while the pandemic is still raging and if the efforts to continue education with the virus are applied long-term.  

Reduction of International Students

International students are part of the education industry and create an environment of diversity and inclusion. In some cases, like tertiary education, they become essential to educational institutions. In most countries, international students pay higher tuition fees than national ones. The lack of them will result in a great hit for most universities. And this is even more true for doctoral programs where international students represent 22 percent of the class. 

With distance learning, things change for international students. They lose the main benefits of being in another country to meet new people and cultures. Plus, they probably have expensive living costs that they could save by moving back to their home countries. The point of going abroad to study is to go to a better university that will provide better opportunities for their careers. And if they, from now on, have to study online, they may have other options like more affordable online courses

Also, in many countries, international students are a source of development. Countries like Australia and Canada facilitate the immigration process to highly qualified students that will improve the country’s chances of development. This could be hindered by the reduced number of people that decide to study abroad. 

More Online Platforms

What immediately changed when the pandemic started back in March was an increase in online learning platforms. Every institution in the education sector, either private or public and from pre-K to tertiary education, had to move to online platforms to continue their operations. By May, 94 percent of learners worldwide were affected. Many of them already had online platforms that they only need to adapt to the new needs. 

But most schools didn’t have any idea where to begin, and they created learning platforms that weren’t that effective. So, they will probably go back to traditional in-person methods when the governments allow it. Other learning institutions, like coding bootcamps, were already offering interactive and user-friendly online platforms. So those will probably continue with this methodology for a while. 

Shared Responsibility

Another thing that changed with the pandemic, especially in primary and secondary education, is that the learning process became a shared responsibility. We are in a society where most families have two working parents, so education was the responsibility of the schools. 

Now, with the pandemic and most kids back at home and parents working remotely, they have at least some of the responsibility in the learning process. Online learning is hard for younger kids. It is difficult for them to concentrate and keep themselves engaged. That is why parents had to step up and become the teachers for a few hours each day. 

In Summary

The Covid-19 pandemic generated an economic crisis in many countries, and this will probably have an impact on education funding in the future. With all the distancing and safety measures, the number of international students will decrease, which is a huge hit for the sector. Plus, many online platforms were created and will probably stay as a new way of learning. 

Categories
General Reflection

Scholarly Pursuits

Growing up, my father didn’t get home from work until nearly 10:30 pm.  He worked full-time at Allstate Insurance while also working part time as a realtor. There were days I didn’t see my father because he had been working all day. He told me to be grateful for what I had and where I was in life. I didn’t fully understand him, until now.

My father was unable to complete his education. He had planned to become an engineer, but his dad fell ill and the responsibility for the family fell entirely upon him. My father had to pay for his sister’s wedding and his younger brother’s education. In order to do this, he quit college and started working full-time.

I look at myself now and see how dramatically different my life is compared to his. I have everything I could dream of and more. My father is willing to work hard so that I can, today, pursue my education at the best of institutions. In fact, since preschool, I have studied in private institutions and grown up in a world that is in diametric opposition, in terms of the opportunities and expectations placed upon me, to the world that my father grew up in. He has tried to prevent me from even getting a glimpse of the hardships he endured when he gave up his dreams to serve his family. I am humbled by and grateful for the opportunities my dad’s efforts have allowed me to pursue. I know that my father did not have many of the same opportunities. As the timeless and enduring quote goes, “with great power, comes great responsibility”- I know that having the access and opportunity to seek and find knowledge comes with expectations- to serve the community which has so selflessly flung all its needs and desires to serve the needs and desires of my generation. I have had the opportunity to attend both engineering and medical school. The knowledge I have gained by attending both these schools has not only empowered me, but has also reminded me of what I owe to my community and my family- the responsibility to give back.

Whenever my father sees me with a calculus or physics book, a smile comes across his face. He begins chanting the trigonometric functions and formulas he remembers. But that smile often fades as he remembers the past. My father has never talked openly about the hardships he endured while he was young, but his eyes convey it all. There was this silence that followed that chanting and smile. I knew that my father was thinking back to his past and the educational endeavors he never had the opportunity to pursue. Despite this, my father is able to provide more than enough for our family on many levels, financial and emotional.

However, despite my dad’s success, there is still a part of him that wishes he could finish his education. I have grown so much from my father’s experiences. Although he did not have the opportunity to finish his education and pursue the engineering career he had dreamt of, his sacrifices came to yield. Family has always been incredibly important to him, and the efforts and sacrifices he has made on his family’s behalf have added immeasurable value to his life.

As I tread through my final months of medical school I’ve come to realize more and more just how fortunate I am. Every day is a reminder of the advantage and opportunities I was granted due to my father’s sacrifices. I am now the same age that my father was when he left school, and I am fully aware of the advantages I have over him. But with these advantages come additional responsibilities. I will forever remember his efforts and sacrifices and do my best to honor them.   It is this passion that is the driving force of my life and my scholastic pursuits.

Featured image:
Opportunity by Susan Frasier