Author Archives: CMAJ

Ever wish you could ask a wise, kind, approachable Student Affairs Dean something without having to admit the question was yours? Maybe you think it’s cringe-worthy; maybe you feel like you should know the answer already; maybe you think you will be judged; maybe you’re sure you are the only medical trainee on the planet ever to have felt this way, and you need confirmation now.

Enter Dear Dr. Horton, a new feature on the CMAJ Blog. Send the anonymous questions that keep you up at night to a real former Dean of Medical Student Affairs, Dr. Jillian Horton, and get the perspective you need with no fear of judgment (rest assured, though — Student Affairs Deans in Canada are all really great people, and not only have they heard it all, but they take on these decidedly unglamorous, 24-hour call jobs because they really, really care about learners).

Submit your questions anonymously through this form, and if your question is appropriate for the column, expect an answer within a few weeks! ...continue reading

Julian Nguyen is a medical student in the Class of 2019 at McGill University

 

Monday morning; flu season. The attending respirologist has spent the whole weekend on call battling the symptoms of influenza, likely caught from one of our many afflicted patients. Swallowing a Tamiflu pill, he tells me how—despite a hectic shift in the emergency room—he managed to complete a major grant application for his next research project. His voice is hoarse from coughing and exhaustion lies around the corner, yet his determination to carry on is unshaken. I admire his fortitude while hating myself for lacking his sense of sacrifice.

Michel Foucault, in his seminal Naissance de la clinique (The Birth of the Clinic), highlights the primordial role physicians occupy in a society predicated on science. He sees in physicians (and priests) “les héritiers naturels des deux plus visibles missions de l’Église — la consolation des âmes et l’allègement des souffrances” (the natural heirs of the two most visible missions of the Church — the consolation of souls and the lessening of suffering). Western society’s obsession with youth and health has elevated physicians beyond mere technicians to all-encompassing healers, increasing the burden placed on aspiring doctors. ...continue reading

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Austin Lam is a medical student at the University of Toronto

 

 

We often hear and use the term “patient-centred care” without having a precise definition in mind. In order to elucidate the meaning of this term, it is important to analyze the concept lying at its centre: the patient. What does it mean to be a patient? What is the core, essential definition of patient?

Some have argued for patient to be replaced with a different term. As someone who has undergone surgeries myself, I have reflected on the meaning of this word and its associated implications. My hope is that this preliminary analysis can help provide directions for future questions, emphasizing an open exploration rather than closing off areas of discussion. ...continue reading

Abhishek Gupta is a research and medical sub-intern at CAMH who graduated from the Windsor University School of Medicine

 

The controversial debate over cannabis legalization has concluded on an official level, legally placing the drug in the hands of the Canadian public. Very soon, anyone over the age of 19 will be able to walk into a store and obtain it for personal consumption.

For mental health professionals, some aspects of this decriminalization effort are appealing. Conventional marijuana is often laced with far more dangerous substances leading to highly dangerous health outcomes. Furthermore, individuals with substance abuse issues are more likely to seek professional help when the consequences of drug possession are milder. Much like needle exchange sites, this move towards legalization provides consumers with a safer alternative for addressing their cravings for cannabis. ...continue reading

Sarina Lalla is a medical student in the Class of 2020 at McMaster University

 

When McMaster medical students learn about medical conditions in a problem-based setting, we frequently use the mnemonic “DEEPICT” (Definition, Epidemiology, Etiology, Prognosis, Investigations, Clinical presentations, Treatment) to approach them. Medical schools focus on teaching students about these important aspects of diseases; with time and practice, this information can be retained and applied by students to make them better clinicians.

However, there is also value in understanding a disease through the eyes of patients. More specifically, it is critical to recognize how facing an illness and navigating the healthcare system impacts their lives. Patients are the experts on their own experiences, and the knowledge they can present in the form of stories can teach us a lot. While we learn how to interpret information in the form of bloodwork and imaging, patients present first and foremost with a story. ...continue reading

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Bader Alamri is an Internal Medicine Resident (R3) at Dalhousie University

 

Since 1978, more than 4,500 Saudi physicians and surgeons have been trained and have provided healthcare in Canada. These individuals have trained and practiced at many university hospitals across Canada over the past forty years, working within a very wide range of specialties—from general residency training to subspecialty fellowships, as well as very specific areas of research and clinical interest [1].

The Royal College of Physicians and Surgeons in Canada (RC) recently signed a Master Executive Agreement with the Saudi Commission for Health Specialties (SCFHS) to increase and improve the quality of training in Saudi Arabia, which reflects the long-standing relationship between the two parties [2]. In fact, the current SCFHS CEO is himself a Canadian-trained gastroenterologist at the University of British Columbia, and the current CEO of RC is a hematologist who established the first bone marrow transplant program in the Kingdom of Saudi Arabia. ...continue reading

At its core, humanism is a concept which weaves together the science and the art of medicine. The American Arnold P. Gold Foundation, established by the Gold family in an effort to “nurture and preserve the tradition of the caring physician,” has been striving to accomplish this since its inception through the development of various programs — including the Humanism in Medicine Award at the Association of American Medical Colleges (AAMC) to honour caring and compassionate mentors in medical school education.

Dr. Sarita Verma, Vice President of Education at the Association of Faculties of Medicine of Canada (AFMC), notes that this ideal — providing compassionate care that is sensitive to patients’ values, as well as the integrity and nature of the physician-patient relationship — resonates quite strongly with Canadian medical students as well. ...continue reading

Arnav Agarwal is an Internal Medicine Resident (R1) at the University of Toronto. Check back the last Thursday of each month for a new featured piece as part of his series (Doc Talks: Reflections to Reality)!

 

Arnav Agarwal, CC3. I starkly recall etching those three words as I signed off on my first clinical note on a warm September morning. I wish this could be in pencil, I remember thinking. The idea of permanently associating my identity with a patient’s story and offering a proposed impression and plan felt outlandish — I barely had my own impression and plan figured out. How was I going to help patients and make a difference when I could hardly find my way to the right area of the hospital for my first day? And, a more weighted question: could I really practice medicine?

Indeed, the two years that followed were defined by gruelling academic intensity unparalleled by the prior two years of pre-clerkship. A rigorous clinical schedule was now paired with the expectation to prove theoretical capabilities every six to eight weeks. Uncountable sleepless overnight shifts on-call were matched by long days and weekend shifts. The unwavering anticipation of new learning experiences was paralleled by the uncomfortable sense of needing to constantly impress those around us and hold our own in a seemingly foreign environment. ...continue reading

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Sabrina Slade is a medical student in the Class of 2019 at Queen's University

 

Let me preface this by saying I am the kind of person who uses sarcasm and humour as a form of coping, and these opinions are my own.

You I have cancer.

A phrase I never could have dreamt would come out of my mouth, yet something I see or speak about almost every day in my so far short-lived medical career.

It’s the last week of June; I’ve just started my internal medicine rotation in Toronto and am rushing to get ready as I have slept through all seven of my alarms. I glance at my phone, noticing three missed calls and a voicemail with a little urgent symbol beside it. It’s my family doctor’s office; I listen to the voicemail half-heartedly as I struggle to pull on my nylons. She says something about biopsy results, and the words “neoplasia” and “urgent referral” stop me cold. I shimmy over to my phone, my nylons awkwardly half on, and hit replay. ...continue reading

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Mohammad Jay is a medical student in the Class of 2020 at the University of Ottawa

 

Dear Mohammad,

As you open this letter, you will have completed the first day of your orientation week. You’re sunburnt and tired, but beaming with excitement. You have met so many people and revelled in your shared enthusiasm about medical school. Remember to hold on to this excitement — not just today, but for the rest of your medical journey.

Although much of this journey will be rewarding and filled with exhilaration, there are going to be days when you’ll feel inadequate, exhausted, or frustrated. Remember the excitement of the first day of O-week during these difficult times. Open your admission email and replay the screams of excitement and the hugs from your family and friends. Despite the challenges of medical training, you are privileged to be on this journey. Remember that you are training to save lives. What could be a greater honour than this? ...continue reading