Hilary Drake is a medical student in the Class of 2021 at the University of British Columbia
On my first day in a new family practice, my preceptor asked me to take a history from a patient who had listed their “reason for visit” as a sore throat. I stood in the hallway and made a mental checklist of questions to ask and observations to make. Have they had any sick contacts? Does their voice sound hoarse?
When I opened the door and asked them if they could tell me what brought them in today, they responded as expected: “My throat is sore.” When I asked what they thought might be causing the pain, they unwrapped a scarf from their neck and stated, “I think it’s because the noose didn’t work.” At that point they started crying.
They had tried to come in before. They had recognized their pain and wanted to reach out for help, but they were unable to out of fear that their physician would not believe the pain if they could not see it.
Mitchell Elliott is a medical student in the Class of 2019 at the University of Toronto
Doctors are amongst the intellectual elite of society. In many cases, with decades of training and continuing education in clinical practice, our expertise grants us the opportunity to do things that would be deemed invasive and inhumane if performed outside of the context of medicine. Selectively poisoning people with chemotherapy; carefully dissecting fascial planes and removing organs; asking invasive and personal questions... all in the name of symptom management, remission of disease, and prolonging the inevitable: death. For physicians, these daily rituals become almost routine. In many cases, we have spent the majority of our lives training for the uncertainty of each day, rigorously memorizing each disease presentation and management principle, habituating to these processes and procedures. With the heavy clinical demands on physicians, it may be difficult to fully realize the impact of our actions on each patient. ...continue reading →
Welcome to this week's edition of Dear Dr. Horton! 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. Submit your questions anonymously through this form, and if your question is appropriate for the column, expect an answer within a few weeks!
Dear Dr. Horton,
With CaRMS applications open, the pressure is definitely piling on... yet no matter how much I tell myself I need to get started on preparing personal letters for the different programs I'm applying to, I just keep putting it off.
I know a great letter isn't going to pop into existence the night before applications are due, but I'm also at a loss in terms of where to even start... any advice would be much appreciated.
Dr Margaret Rundle is a Family Physician practicing in Scarborough, Ontario
There is little dispute among care providers that a person’s dietary habits influence preventative and treatment outcomes. Every year, there is more research validating the role of food and therapeutic diets for chronic disease management and prevention. However, basic education around the role of nutrition and lifestyle for a long time has been a blind spot in the Canadian medical school system. ...continue reading →
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 →
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 →
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 .
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 . 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 →
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, 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 →
Mohammad Jay is a medical student in the Class of 2020 at the University of Ottawa
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 →