Tag Archives: medical education

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Imaan Javeed is a medical student at the University of Toronto.

 

Warming up my dinner in the microwave, I habitually open the YouTube app to see what's going on in the world. Before the microwave can finish whirring, though, it suddenly occurs to me: do I even like this stuff?

I’m talking, of course, about politics.

I must, right? For a pill I take religiously every day, multiple times a day, which occupies an embarrassingly large chunk of my attention, you'd think it would be something I at least enjoy. The thing is, though, for me, it doesn't feel like a choice. It's not voluntary, nor is it just a hobby or a game. It's an obligation.

I would be lying, of course, if I told you it didn't give me that addictive rush, complete with the Netflix-like drama and cliffhangers that keep a person coming back for more. I fall down social media and news media rabbit holes as I ravenously devour new social, political and economic studies, polling, data, investigative work, news, and even opinion pieces. I get excited about participating, happy when my team is winning and frustrated when they're losing.

However, while it's easy to use trite analogies, the politics of today is anything but a game. Human lives are at stake each and every day. As abstract and unlikely as it sounds, even small acts of activism can help alleviate some of their suffering, bring them justice and make their lives easier. At the same time, our silence can do the opposite.

As future physicians, whose job it will (hopefully) be to care for the sick and vulnerable, and who take an oath to work for the greater societal good, knowing where to throw our political weight and understanding the power structures that operate to affect countless aspects of people's lives is a hefty yet important responsibility to carry.

Yet carry it we must – and while we're at it, help others to carry it as well. To remain disengaged or apathetic plays into the hands of those few in the system who work tirelessly (knowingly or unknowingly) in ways un-aligned with the public interest. If we're not present and ready to throw out the people who either aren’t working for us or simply aren’t the best candidates for the job, it serves as permission for them to keep doing what they're doing. Likewise, if we like the way things are going, we should show and up and make that known, or risk it changing under our noses. Our democracy relies on public accountability: accountability, that is, to you and your patients.

It's not enough to stick our privileged heads in the sand and refuse to engage, or engage with an air of entitled self-interest. Silence and blinders are statements in and of themselves. In a democratic society, these are choices we cannot escape with disengagement.

Nor is it enough to narrow our engagement to that which can be labelled as "healthcare related," like on topics of pharmacare, mental health, and MD remuneration. We may have the most expertise here, and valid opinions on the issues, but it would be short-sighted to stop at this.

Virchow once famously said that “politics is nothing else but medicine on a large scale.” It's true – a persons health is inseparable from the rest of their life. Their wages, working conditions, education, housing, food, stigma, discrimination and more all play roles. Broader issues like wealth inequality and climate change are also linked to health outcomes in countless ways, both subtle and overt, in Canada and around the world. Indeed, sometimes we become so focused on individual impacts on the people in our offices (ex: how disease presentation may be affected by social and environmental determinants) that we lose sight of the patients we may never meet face-to-face (ex: populations displaced by increasingly-harsh weather events or wars, or those prioritizing finding family housing over their health). Much like in clinical decision making, insular mindsets can deter us from taking properly-informed, well-nuanced stances on social issues. And especially as people of privilege, we have the opportunity to sway the people around us. This is key, as the medicine of politics is one that must be administered by a collective – both the choice of treatment and its dosage is controlled by collections of much smaller units.

Furthermore, for a truly holistic view, as citizens of a relatively wealthy, privileged, and influential nation, in order to give the global community we serve our full support, we must fight for the well-being of our patients not only here but beyond our borders, starting by staking clear stances on fundamental human rights. Our scope should include everyone -- from the workers struggling to pay rent in Toronto, to the rural Indigenous family without access to clean water, to the starving child in Yemen who has known nothing but war. We should feel a responsibility towards anyone who's life and health could be affected by our actions, no matter how far down the line.

I know it can be overwhelming to think about. Luckily, not everyone needs to become a politics junkie overnight. Start small. Have informal conversations with knowledgeable people, read and watch the news, maybe even get your friends involved to learn together. I understand that no one can do everything at once. The days are long and exhausting. However, it's worth asking ourselves at the end of the day: are we simply perpetuating what doesn't work, or are we doing our best to take part in changing it?

Making my tiny contribution to greater societal change is what I signed up for as a doctor-to-be. Politics is an inseparable part of that.

So, maybe I do like it. Maybe just a little.

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Jovana Milenkovic is a PGY2 in Pediatrics at the University of Calgary.

Ready is what I was.

A week of what should have been pure relaxation on the beaches of the Caribbean, was ruined by the torment of my special sixth sense. You see what I refer to as my sixth sense, is this twist deep in my stomach that always comes before something, usually bad, is going to happen. It came before I lost my first patient during clerkship. It came before my grandfather fell and broke his hip. It continues to come as a subconscious warning to brace myself.

We arrived at the airport, ready to head back home. While checking in, a passenger became unwell and was pulled to the side by the medical team. I watched as they took out a simple blood pressure cuff, “I haven’t had to use one of those since medical school, it’s all electronic now,” I commented to my mother. The twist in my stomach tightened.

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Due to the sensitivity of the post, the author wished to publish the following piece anonymously. 

Dear potential Referee,

My name is Jane Doe, medical student and residency applicant. So nice to meet you. You are the 30th new staff that I have worked with in the past 15 months and among the over 100 physicians and residents who I’ve met and had to prove myself to across many disciplines and hospitals in our fair country.

So excited to be working with you, to learn from you and to incorporate some of the approaches and expertise that you have into my slowly forming future practice. Look at all that I know how to do! Please appreciate all the additional readings I have done. Did you notice that I’m wearing a perfectly professional outfit with properly groomed hair? I’m actually living out of a suitcase and couch surfing in a city I have never been to that I paid hundreds of dollars to come to just so that I could have the opportunity to spend the day with you today. ...continue reading

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Maureen Topps is the Executive Director and CEO of the Medical Council of Canada.

 

Nothing matters more in my role than helping Canadian and international medical graduates succeed as they prepare to practice medicine in Canada. But what does success look like and how do we measure it?

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Ever wish you could ask a wise, kind, approachable Student Affairs Dean something about CaRMS, without having to admit the question was yours?

Enter Dear Dr. Horton. Send the anonymous CaRMs questions that keep you up at night to a real former Dean of Medical Student Affairs, Dr. Jillian Horton. We will use your questions to shape a special upcoming CaRMS podcast.

Submit your questions anonymously through this form.

See an example from last year: CaRMS interview tips!

Grace Zhao is a third year MD/MSc student in the Systems Leadership and Innovation program at the Institute of Health Policy, Management and Evaluation.

 

Ontario is undergoing its biggest health system reform in 50 years. Under Premier Doug Ford, 20 health agencies will be merged into a superagency – Ontario Health. The rationale behind this is to eliminate duplicative back office infrastructure and administration in order to streamline work to achieve integrated and coordinated care. The functional unit would be the Ontario Health Teams, which are made up of local health care providers who work together to provide coordinated care through technology.

With much attention being placed on health systems innovation and transformation, I asked two health system leaders on their thoughts about leading system innovation and transformation and the current climate of Ontario’s health care system. ...continue reading

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Caitlin Dunne is a Co-Director at the Pacific Centre for Reproductive Medicine (PCRM) in Vancouver and a Clinical Assistant Professor at the University of British Columbia.

 

A new study published in the Journal of the American Medical Association (JAMA) Pediatrics has linked fertility treatment with a risk of childhood cancer. The researchers linked data on babies from an American fertility database with birth and cancer registry data from 14 states. Their study spanned an eight-year time period, including 275 686 children conceived by in vitro fertilization (IVF) and 2 266 847 children who were conceived naturally. The focus was on young children, up to four and a half years old. ...continue reading

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Emily Harris is the Business Manager for the Heart and Vascular Program at Unity Health Toronto – St. Michael's Hospital

 

Healthcare is a varied and multidisciplinary world. From clinical medicine to social work to data collection, expertise from many diverse specialties is required to ensure that hospitals run successfully and that patients receive the very best care.

The value of a collaborative environment in healthcare is ...continue reading

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Marcy White is a writer and special needs advocate.

 

In just one year, my son, Jacob, was put on Bi-Pap in the PICU on four separate occasions. Only a respiratory therapist was allowed to put the device on him or make adjustments when he was in the hospital. On the first occasion, he was not allowed on any other hospital unit while dependent on Bi-Pap. On subsequent occasions, he could transfer to the General Pediatrics unit as long as his Bi-Pap needs remained stable but, should his Bi-Pap needs increase, he would be transferred back to the PICU. ...continue reading

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Curtis Sobchak is a medical student in the Class of 2019 at the University of Toronto

 

It is well-known that workplaces strive for diversity and inclusion. Studies have shown that diversity improves productivity and contributes to creativity and new ideas. In medicine, this diversity is just as important. Having physicians from under-represented and marginalized communities provides unique views on what may be best for the patient. As medical schools continue to support new initiatives, such as specialized admission pathways for African American and Indigenous students, it is clear diversity is on the agenda. However, for those who are not of the majority ethnicity, diversity may not be enough. There also needs to be representation.

This idea was at the forefront of my mind during an elective rotation. After I had mentioned my interest in Indigenous health a number of times, I was asked by my attending whether I was of Indigenous background. I understood the hesitation, of course; sometimes it can make people feel uncomfortable to ask about your background or where you are from. Nonetheless, I was happy they had asked and I responded with a firm “yes.” ...continue reading