Tag Archives: medical training

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,

Over the past month, much of what is occurring in our political and social climate has been serving as a constant reminder of inappropriate behaviours/sexual harassment I've experienced as both a patient and a medical learner.

Do you have any advice in navigating these feelings?

Signed,

Demoralized

Dear Demoralized,

...continue reading

1 Comment

Mohamad Matout is a Psychiatry Resident (R1) at McGill University

 

The debate regarding what should future doctors be learning during medical school is sensitive and convoluted. During the four years in which students learn basic sciences and acquire basic clinical knowledge, due to lack of time, little is taught with regards to major topics such as nutrition1, lifestyle changes, oral health2 and basic computer literacy3. One could argue that psychology is another field in which future physicians lack structured education. Our curriculum is usually centred around understanding the biology of pathophysiology and, when possible, the neurobiology of psychopathologies. While we may be introduced to the area of psychology and an understanding of pathologic defense mechanisms, the world of psychotherapy remains mysterious to medical students and physicians in general. ...continue reading

Giuliana Guarna is a medical student in the Class of 2019 at McMaster University

 

Knock, knock.

I pulled back the large door and stepped into the room. It was early in the morning — just after 6 am. She was lying in bed, awake, with a smile on her face despite the fact that she was post-op. The evidence of surviving rounds of chemo were borne out in front of me. Her hair was peach fuzz, peeking through a silk turban wrapped around her head. Her cheeks were like little Timbits, but her frame was swallowed by her hospital gown.

“Oh, hi. Come in. Let me turn on the light.”

I walk to the foot of the bed. The sun had not yet peeked out from under the shades. The room was illuminated by a yellowish-white hospital glow as she pressed the switch.

“How are you today?” ...continue reading

June Duong is a medical student in the Class of 2019 at Queen's University

 

Author’s note: This is a satire inspired by #tampongate on Twitter, which occurred on October 27, 2018 in response to policies regarding the use of menstrual hygiene products during the MCCQEII. All characters in this work are fictitious. Any resemblance to real persons, living or dead, is purely coincidental.

Dr. John Doe woke up on Saturday morning and cooked himself a large breakfast. It was doomsday, for he would be doing his exam this weekend. He was going to be out all day. He did not know whether he would be doing the exam in the morning or in the afternoon — not that it mattered in the end, since he would be sequestered for the rest of the time anyway. As far as the instructions he’s been provided with, all they said was, “Do not bring food. A light snack will be provided depending on your examination schedule.” Dr. Doe, with his three degrees, translated this statement into a big, fat maybe. You may get food so that you can focus on your exam, or you may have an empty stomach gnawing away at itself. ...continue reading

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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,

Looking back, I know there were many reasons I wanted to enter this field — but with the overwhelming and increasingly hectic nature of medical training and residency, it’s sometimes easy to forget what those were.

I don’t want to become jaded so early in the game, but can feel some of my initial idealism ebbing away and cynicism setting in. What are some ways to remind ourselves of our passion for medicine?

Signed,

Burning Out

...continue reading

Serena Arora is a medical student in the Class of 2019 at McMaster University

 

I love puzzles.

I love looking at the picture on the box, seeing what the completed version will look like and then pouring out all the little pieces — knowing that, somehow, they all come together to create something.

In some ways, practicing medicine is like doing a puzzle. It’s complex, intersecting, and incredibly rewarding when done right. At the same time, medicine is fractured into a thousand different components.  As physicians, we look at our patients and we piece them apart into organs and body systems and tissues. We rip the details we think are important from the fabric of their narrative to focus on specific complaints. We take their words and distill them into our jargon, often so much so that their original story would be unrecognizable. Medicine is often an act of reductionism.

If medicine is a puzzle, then palliative care is like the picture on the box. ...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)!

 

Once an elastic band is stretched beyond its limits, it is difficult for it to return it to its unstretched state. Burnout represents a similar phenomenon: an erosion of one’s sense of self and a reflection of emotional over-exhaustion, leading to disinvestment and depersonalization. Years of intensive training, long working hours, increased managerial responsibilities, resource limitations, emotionally-involved patient and family encounters, fear of limited job prospects and litigation, and mounting clinical and non-clinical responsibilities, among other demands: physicians and other health care professionals represent a highly vulnerable group susceptible to burnout, with some estimates suggesting close to 50% of physicians being affected. Evidence suggests that physicians experiencing burnout are more likely to make poor medical decisions, share more tenuous relationships with co-workers, experience more individual and personal relationship challenges, and suffer higher risks of anxiety, depression, and suicidality. Physician burnout has also been associated with differences in overall quality of care, system-level costs, and rates of staff turnover and absenteeism.

This piece focuses on the compromise some residents and physicians make in placing themselves second while dedicating themselves to the care of others, and the silence that some encounter while struggling with burnout. It is encouraging to observe that dialogue around burnout and mental health is growing at individual, institutional, and systemic levels over time. This piece is part of that conversation. ...continue reading

1 Comment

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,

It seems everyone is always talking about the importance of having a strong support system around you. While I’ve managed to make casual acquaintances among the pool of colleagues and co-learners I see from time to time, these relationships feel fairly superficial. Yet no one seems to have the time to forge deeper connections...

How do you build your "tribe" in medicine, given how busy everyone is?

Signed,

Lone Wolf

...continue reading

6 Comments

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

Alastair McAlpine is a fellow in paediatric infectious diseases at BC Children's Hospital in Vancouver

 

People sometimes ask me, "What’s the difference between medicine in Vancouver and medicine in Cape Town?" The answer is, quite simply, Everything.

But let’s rewind a bit. In July of this year, I flew the 20 or so hours it takes to get from South Africa to Vancouver. I arrived in the city by myself with 2 suitcases, knowing hardly a soul, and feeling completely overwhelmed. A few months earlier, I had been accepted into a 2 year paediatric (even the spelling is different) infectious diseases program at BC Children’s Hospital. Before coming I had filled out endless paperwork, done a million online courses ...continue reading