Shaun Mehta is an Emergency Medicine Resident (R4) at the University of Toronto
In elementary school, I always dreaded bringing my report card home. My grades were good, but the teachers’ comments that followed could go either way — and were unfortunately of much more interest to my parents. I was often described as “disruptive,” and it seemed that relinquishing this quality was the key to making something of myself.
Two decades later, I’m finding out that being disruptive is one of my most valuable assets.
To clarify, we probably shouldn’t praise students for being disruptive in the classroom. But outside of the classroom... now, that’s an entirely different story. The health care industry is ripe for disruption; strapped for cash and bursting at the seams, we need better ways to manage today’s volume and complexity of patients. Forward-looking individuals and organizations have heeded the call and are making huge strides in health care innovation, yet patients continue to suffer as a result of systems-level issues.
By shifting our paradigm of innovation, creating an environment to foster disruption, and educating future leaders to drive change, we stand a chance at driving maleficent creatures (like hallway medicine and eternal wait times) to extinction. ...continue reading →
Han Yan is a Neurosurgery resident at the University of Toronto
Much attention has been paid of late to the phenomenon of social echo chambers - situations in which people’s beliefs are amplified and repeated in a closed system as no dissenting opinion originates from within the group. Echo chambers on social networking platforms such as Facebook and Twitter were identified as a factor contributing to the outcome of the 2017 US Presidential Election. We believe that social echo chambers exist in the real (non-digital) world as well, within social groups whose members may interact outside the group in general, but who discuss particular subjects only within the group. ...continue reading →
Ruth Habte is a medical student in the Class of 2019 at the University of Manitoba
I have been privileged to take part in implementing global health programming while in medical school, both at my own school and across the country. Throughout this time, I have often been prompted to answer the infamous question: “What is global health?” I have also encountered the misconception of global health being synonymous with international health. Based on my learning and experiences, I have come to define global health in my own terms.
While global health is an incredibly broad field, the cornerstone of global health (in my opinion) is attaining health equity for all people. That means that a person with less privilege in life should be afforded greater means to reach the same health outcomes as those with more privilege. ...continue reading →
Pieces of a puzzle inherit meaning not by their individual qualities, but by being pieced together into context. Good medicine — and good healthcare — are similar: they rely on understanding patients as people, and clinical presentations as brush-strokes forming part of a bigger picture....continue reading →
Earlier this fall, over the course of a tense dinner table discussion, it came to light that a dear relative of mine held some blatantly transphobic beliefs. I was greatly distressed by this — not only because these beliefs were at complete odds with my own, but because I had no idea what to do. I felt that it was my responsibility to educate them and keep communication channels open... but having had little success with blunt confrontation, I was at a loss.
Then I read First Year Out: A Transition Story, the second graphic novel by Vancouver-based author Sabrina Symington. First Year Out describes the story of Lily in her first year as an openly trans woman, and covers everything in Lily’s life from the basics (such as how she gets dressed and her first experience with online dating) to the harder conversations (like confronting her mother about her TERF [trans-exclusionary radical feminism] attitude and telling her boyfriend that she wants sexual reassignment surgery). Through the incredible medium of graphic story-telling, we get to literally see how Lily grows into herself. ...continue reading →
Rashi Hiranandani is a medical student in the Class of 2019 at the University of Ottawa
Medical school is a stressful time in students’ lives. There are emotional, physical, and mental stressors; particular daunting is the stress of being in new clinical environments on a weekly or even daily basis and having patients’ lives in our hands. Medical students are sleep deprived and over-worked. We have the stress of not matching to the residency of our choice or even not matching to a residency program at all. Medical students also experience significant burnout and compassion fatigue, with burnout rates ranging from 27 to 75% . It thus comes as no surprise that medical students suffer from rates of mental illness higher than the general population. This is not ideal for the health of the medical students, nor is it optimal for the health of the patients they care for.
A 2016 systematic review published in JAMA reported that, on average, 27.2% of medical students deal with depression or depressive symptoms . Among students who suffer from depression, only 16% receive help . ...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,
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?
Domhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK.
Research conferences should be an opportunity to gain insights from discussion and collegial debate about new research. At times, though, I have seen debate become adversarial and counterproductive; questions can be aggressive and speakers defensive. But one of the great attributes of the North American Primary Care Research Group annual meeting (NAPCRG) is the culture intellectual rigor yet respectful and collegial discussion, and the support for early career researchers. Researchers with impressive track records in publication in international journals are always keen to share their knowledge and help their colleagues. David Meyers, a long time NAPCRG supporter unable to attend the conference this year due to illness sent a video message in which he said, "May you find meaning in your work and friendship in your colleagues." ...continue reading →
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 →