Sahil Sharma is a medical student in the Class of 2020 at Western University
Nearing the end of my first year in Medical School, I am amazed by the wealth of knowledge acquired during such a short time. There have even been several moments throughout the year where picturing myself as a fully licensed physician seemed slightly less daunting. I have become comfortable with routine physicals, certain diagnoses, different drugs, and management of a wide range of illnesses. I have no doubt I will encounter each of these facets of healthcare during my career. However, there is one unavoidable aspect of medicine that has been discussed very little: death.
The discussion of death is, understandably, quite sensitive; thus, discussing it with such a diverse demographic of students requires a certain amount of skill and reserve. But after learning about concepts such as palliative care and patient-physician relationships, it seems unjust to gloss over one of the most vital roles of a physician — the ability to comfort patients in their most troubling times. ...continue reading →
Chloe MacAuley is an intern (junior doctor) at Tallaught Hospital in Ireland who graduated from medical school at Trinity College Dublin in 2017
Armed with an email outlining the ‘Dangerous Abbreviations NOT to Use’, a certificate showing I had passed an online test on how to use the hospital computer system, and a dictation number — what was a dictation number? I wondered — I boarded my plane from Dublin to Vancouver for a medical student summer elective.
Canadian students in my class at Trinity College Dublin had warned me that Canadians expected more of a hands-on approach from their medical students. Navigating the unfamiliar streets to St. Paul’s Hospital on my first day in downtown Vancouver, I was thinking about how much easier it would have been to stick with the familiar commute to St. James’s Hospital in Dublin. I was nervous, but I had resolved to throw myself in the deep end before final year. ...continue reading →
Boluwaji Ogunyemi is a Dermatology Resident Physician in Vancouver, BC, and a freelance writer for the Huffington Post, Ubyssey Newspaper, and the Online Journal for Community and Person-centered Dermatology
Few topics evoke as much controversy and emotion as that of race.
Though much has been said about differences in the physiology of minority groups seen as “other”, there exists no clear consensus of the meaning and utility of these findings.
Through much of the 19th and early 20th centuries, medical experiments were performed on vulnerable populations including the infamous Tuskegee University-affiliated investigation concerning “Untreated Syphilis in the Negro Male” and those carried out by the Third Reich.
It is, in fact, a physician whom we can credit - or blame - with being the first to use the term “race.” In his 1684 novel ...continue reading →
Kira Payne MD, FRCPC, is a recently retired psychiatrist and jazz musician living in Toronto, Ontario
You would think it would be easy to be an expert in the information age: all those books and journal articles, indexed in libraries, ready and waiting to be perused; all those digital bits and bytes coursing through the internet, searchable on academic databases or Google; all those archived videos on You Tube providing information on everything from how to calculate Pi to how to fold a t-shirt in only 2 seconds. Wikis abound, democratizing information, enabling it to exist in a continuously amendable form. Information is everywhere and growing exponentially. It is “kid in a candy store” stuff, right? But there is something sinister about the overabundance of information. Reminiscent of a Grimm fairy tale, there is the very real possibility of paradoxical starvation despite the bounty. ...continue reading →
Michelle Greiver is a family physician with the North York Family Health Team in Toronto
As a family doctor, I sometimes wonder if I provide too much care for some patients in my practice. Do my elderly patients with diabetes need very low A1Cs? What about the risk of falls and fractured hips due to hypoglycemia associated with enthusiastic use of diabetic medications? Should patients over the age of 90 really be on a statin? Should they be on anything that does not improve their quality of life? Perhaps I should be asking them what they would like? ...continue reading →
Nobody could have predicted the desperate state in Syria when the World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (WONCA) Europe Conference for 2015 was awarded to the Turkish Family Medicine Organisation (TAHUD) a few years ago. Few could also have predicted that Turkey would be at the very centre of a mass exodus of people not seen in Europe since the Second World War. According to the UNHCR as of September 2015 the country now finds itself providing refuge to an estimated 2 million Syrians fleeing conflict and destitution. I have heard the current situation being described as a ‘stress test’ of the European values of solidarity and collegiality, ...continue reading →
Recently, members of the health care community and the public at large mourned the loss of neurologist Dr. Oliver Sacks. My grandfather, also a neurologist, sent me one of Dr. Sacks’s books when I first expressed an interest in applying to medical school. I have since enjoyed many of his other written works.
Earlier this summer, the health care community also lost another tremendous leader, Dr. David Sackett, the father of evidence-based medicine. On my first day of medical school, I remember receiving one of his books too, and to this day it remains a fixture on my bookshelf as a resource.
It may seem odd to bring these two doctors together, because they held such divergent views of the clinical world. ...continue reading →
Robyn Thom is a PGY 1 psychiatry resident at Harvard Longwood
It was a winter afternoon when I came to the shocking realization that although I was only months away from becoming a doctor, there was a significant subset of the Canadian population that I lacked the medical knowledge to care for. I was working at the Gender Identity Clinic at the Centre for Addiction and Mental Health (CAMH), where patients undergo psychiatric assessment to qualify for provincially-funded gender reassignment surgery. There, not only did I find myself listening to my patients rattle off multiple behavioural, hormonal, and surgical options for gender transition that I had never heard of before, but I also gained an appreciation for the degree to which skilled healthcare for transpeople in Ontario is lacking. ...continue reading →
Multimorbidity is usually defined as present when people have two or more chronic conditions. It’s an idea that appeals to medical generalists because it makes clear that specialist care that only focuses on one of those conditions may sometimes be too narrow, particularly when someone has very many conditions or when the conditions they have are very different. Physical and mental health conditions are the exemplar of the latter, with many countries having separate services ...continue reading →
The practice of evidence based diagnosis is what we are taught we should all do, but, in practice, this is quite difficult. EBM diagnosis relies on likelihood ratios, but it’s impossible to remember the diagnostic accuracies of the thousands of tests that exist.
This is why I made a simple tool to help with the scientific diagnosis of diseases spanning most specialties. It is a database of over 700 likelihood ratios of tests (history, radiology, physical exam etc.). The likelihood ratios are completely free for all to access ...continue reading →