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Emergency Medicine, Medical Education

“We are a team”: Advice for new residents from chief residents, in their own words

"We are a team": Advice for new residents from chief residents, in their own words

1024px-Flickr_-_Official_U.S._Navy_Imagery_-_U.S._Naval_Academy_plebes_carry_a_log_as_part_of_teamwork_training_during_Sea_Trials.There are many things chief residents want new residents to know right out the gate, but much of that goes unsaid. So the blog Academic Life in Emergency Medicine recently put together a list titled “Dear Residents: 10 Things Your New Chiefs Want You to Know.” Each one was written by a different chief resident, as part of the blog’s Chief Resident Incubator project.

It’s a thoughtful collection of reflections that offers an interesting mix of poignant comments and practical advice. The full list is worth a read, but a few stand out:

 “WHEN YOU FEEL LIKE CRYING, CRY TO ME.”

…Know that every one of your attendings and senior residents continue to go through these same trials. When you find yourself on the ropes and feeling utterly alone, call us. We might not be able to make that Surgical ICU rotation any less painful, but we’ll at least buy you a beer and share some stories from our own days working the surgery salt mine.

(Rory Stuart, Chief Resident, Wright State University, Dayton, OH)

WE ARE A TEAM

…Our learning should not only take place during scheduled conference time; we can all learn from each other. Share your successes and failures. Teach us all what you know, and what you wish you would have known. When we get out on our own, we all represent this residency program. Together we can make each other and this program better.

(Valerie Cohen, Chief Resident, Christiana Care Health System, Newark, DE)

NEITHER RESIDENCY NOR LIFE ARE FAIR. USE IT AS AN OPPORTUNITY TO SHINE

…Your week long string of night shifts was not borne of malice or vendetta. We try to make decisions that are in the best interest of the program and we ALWAYS consider your requests.

Your faculty, chiefs, and colleagues are paying attention to how you react to these perceived slights. When you take that extra shift in stride, we’ll notice. When you take on a task that nobody else stepped up for, we’ll notice. When you swap into a weekend night shift so a co-resident can celebrate an anniversary or birthday, we’ll notice.

(Jimmy Lindsey, Chief Resident, University of Chicago, Chicago, IL)

Previously: Soon-to-be medicine resident reflects on what makes a good teacher, Keeping an even keel: Stanford surgery residents learn to balance work and life and A call to action to improve balance and reduce stress in the lives of resident physicians
Via Wing of Zock
Photo by U.S. Navy

Events, Medical Education, Medical Schools, Science, Stanford News

Stanford Medicine grads urged to break out of comfort zone, use science to improve human health

Stanford Medicine grads urged to break out of comfort zone, use science to improve human health

On Saturday, 195 graduates of the School of Medicine sat under a large white tent on the Alumni Green pondering the next chapter in their medical training. Many of them hadn’t been sure if they would make it to this milestone and, for some, the future seemed uncertain. But the message from Lucy Shapiro, PhD, a recipient of the National Medal of Science, was clear, “Step out of your comfort zone and follow your intuition,” she said. “Don’t be afraid of taking chances. Ask, ‘How can I change what’s wrong?'”

Shapiro told the Class of 2015 how she spent years performing solitary work in the laboratory before she “launched a one-woman attack” to influence health policy and battle the growing threat of infectious disease on the global stage. My colleague Tracie White captures Shapiro’s powerful speech in a story today about the commencement ceremony:

Her attack began with taking any speaking engagement she could get to educate the public about antibiotic resistance; she walked the corridors of power in Washington, D.C., lobbying politicians about the dangers of emerging infectious diseases; and she used discoveries from her lab on the single-celled Caulobacter bacterium to develop new, effective disease-fighting drugs.

Her lab at Stanford made breakthroughs in understanding the genetic circuitry of simple cells, setting the stage for the development of new antibiotics. Shapiro told the audience that over the 25 years that she has worked at the School of Medicine, she has seen a major shift in the connection between those who conduct research in labs and those who care for patients in clinics.

“We have finally learned to talk to each other,” said Shapiro, a professor of developmental biology. “I’ve watched the convergence of basic research and clinical applications without the loss of curiosity-driven research in the lab or patient-focused care in the clinic.”

grads walkingShapiro went on to tell the audience that bridging the gap between the lab and the clinic “can make the world a better place.” Lloyd Minor, MD, dean of the School of Medicine, agreed with these sentiments and told graduates that there has never been a better time for connecting advances in basic research with breakthroughs in clinical care. “You are beginning your careers at an unprecedented time of opportunities for biomedical science and for human health,” he said.

The 2015 graduating class included 78 students who earned PhDs, 78 who earned medical degrees, and 39 who earned master’s degrees. Among them was Katharina Sophia Volz, the first-ever graduate of the Interdepartmental Program in Stem Cell Biology and Regenerative Medicine. “Everybody here is reaching for the stars. We can do the best work here of anywhere,” she said.

Previously: Stanford Medicine’s commencement, in pictures, Abraham Verghese urges Stanford grads to always remember the heritage and rituals of medicineStanford Medicine honors its newest graduatesNational Medal of Science winner Lucy Shapiro: “It’s the most exciting thing in the world to be a scientist” and Stanford’s Lucy Shapiro receives National Medal of Science
Photos by Norbert von der Groeben

Medical Education, Stanford News

Stanford Medicine’s commencement, in pictures

Stanford Medicine's commencement, in pictures

Congratulations to Stanford Medicine’s Class of 2015! They were honored during a commencement ceremony on campus on Saturday morning, and photographer Norbert von der Groeben was there to capture the smiles, cheers and (happy) tears.

Previously: Coming up: A big day for Stanford Medicine’s Class of 2015, Abraham Verghese urges Stanford grads to always remember the heritage and rituals of medicine and Stanford Medicine honors its newest graduates
Photos by Norbert von der Groeben

Events, Medical Education, Medical Schools, Stanford News

Coming up: A big day for Stanford Medicine’s Class of 2015

Coming up: A big day for Stanford Medicine's      Class of 2015

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Tomorrow, Stanford Medicine’s graduating class will walk away from campus with a new title: Doctor!

The speaker for the medical school commencement will be Lucy Shapiro, PhD, whose unique worldview has revolutionized the understanding of the bacterial cell as an engineering paradigm and earned her the 2014 Pearl Meister Greengard Prize and the National Medal of Science in 2013. The diploma ceremony will be held on Saturday from 11 a.m. to 1 p.m. on Alumni Green in front of the Li Ka Shing Center for Learning and Knowledge.

All of us at Scope wish the very best for the new graduates.

Previously: Match Day at Stanford sizzles with successful matches & good cheer, Abraham Verghese urges Stanford grads to always remember the heritage and rituals of medicine and Stanford Medicine honors its newest graduates
Photo by Andrew

Medical Education, Mental Health, Nutrition, Stanford News, Surgery

Keeping an even keel: Stanford surgery residents learn to balance work and life

Keeping an even keel: Stanford surgery residents learn to balance work and life

med students in sailboat

Residency is one of the most intense times in a surgeon’s training, and it can take a toll physically and mentally on newly minted medical school graduates as they learn to cope.

To help them counter that stress, Stanford’s Department of Surgery started the Balance in Life Program for its residents. The program, and one of its team-building exercises – a sailing lesson in one of the world’s best sailing spots, the San Francisco Bay – were highlighted in a recent Inside Stanford Medicine story.

As described in the piece, the program is dedicated to the memory of Greg Feldman, MD, a former chief surgical resident at Stanford who committed suicide in 2010. The program provides basics like easy-to-access healthy meals, group therapy sessions and social activities, and Ralph Greco, MD, the program’s director said of it:

A lot of people would argue with the notion that such a program is necessary… I know our day of sailing may raise some eyebrows, but our faculty decided that we should do whatever we could to give these young people the tools they need to help them deal with the vicissitudes of life and medicine through the rest of their careers.

The article also notes that the program attracts residents interested in work-life balance to Stanford:

“The fact that we have this Balance in Life Program is great for recruitment of like-minded individuals,” [resident Micaela Esquivel, MD,] said. “I can tell medical students considering us that they would be hard-pressed to find another program that cares enough about their well-being to offer what we do.”

Previously: A call to action to improve balance and reduce stress in the lives of resident physicians, Surgeon offers his perspective on balancing life and work, Program for residents reflects “massive change” in surgeon mentality and New surgeons take time out for mental health
Photo by Norbert von der Groeben

Cancer, Medical Education, Stanford News, Surgery, Videos, Women's Health

Why become a doctor? A personal story from a Stanford oncologist

Why become a doctor? A personal story from a Stanford oncologist

Why become a doctor? It certainly isn’t easy, and it requires years of study and a sizable financial investment. If you ask physicians how, and why, they selected their careers, you’ll get a variety of stories that offer insight into the many benefits of pursuing medicine.

Pelin Cinar, MD, a GI oncologist here, tells her own story in this recent Stanford Health Care video.

As a child, Cinar was impressed with the respect her uncle, a gynecologist, received from family members. Then, in high school, her mother was diagnosed with cancer. Meanwhile, she began pursuing the courses that matched her interest in science. Her mother recovered but then relapsed when Cinar was in college and taking pre-med requirements.

During her medical education at the University of California-Irvine, Cinar discovered that all of her favorite rotations and subjects were based on oncology. “It took off from there,” she says in the video.

Previously: Students draw inspiration from Jimmy Kimmel Live! to up the cool factor of research, Stanford’s senior associate dean of medical education talks admissions, career paths and Thoughts on the arts and humanities in shaping a medical career

Evolution, Global Health, Medical Education, Research, Stanford News

Stanford med student/HHMI fellow investigates bacteriophage therapy as an alternative to antibiotics

Stanford med student/HHMI fellow investigates bacteriophage therapy as an alternative to antibiotics

IMG_5145 croppedSecond-year medical student Eric Trac isn’t one to shy away from a challenge. Trac’s family is from Vietnam and he didn’t speak much English as a child, but Trac and his mother overcame this hurdle by practicing English and studying together every night until the early morning hours so he could do well at school. Now, just 12 years later, Trac is a Howard Hughes Medical Institute (HHMI) fellow taking on a new kind of challenge: investigating an alternative to antibiotics.

Many people think that antibiotics are the only way to kill bacteria, but this isn’t true. “Before we used antibiotics, we used bacteriophages,” Trac said. “Just like viruses attack people, bacteriophages attack bacteria. In other words, bacteria can get sick as well.”

Bacteriophages have been used since the early 1900s in countries like France, Poland and the U.S. to treat diseases such as cholera and dysentery. But interest in bacteriophage therapy, and its use, declined in the West after antibiotics were discovered in the 1920s. Now that bacteria are becoming increasingly resistant to antibiotics, researchers in the West are taking interest in the decades of bacteriophage research that continued in Eastern Europe and the former Soviet Union long after antibiotics became popular elsewhere. Unfortunately, many of these studies don’t meet the scientific standards (e.g., double blind studies, experimental controls) that Western drug research requires.

So, for his year-long HHMI project, Trac and his mentors, bioengineer and physicist Stephen Quake, PhD, and pediatric pulmonary expert David Cornfield, MD, will test bacteriophage therapy — with the required scientific protocols — to see if it could be a viable, and safe alternative to antibiotics. His project will focus on two common bacteria, Pseudomonas aeruginosa and Staphylococcus aureus, that can cause life-threatening infections, especially in people with cystic fibrosis. “The need for alternative ways to kill these two bacteria is great,” Trac said.

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Medical Education, Medicine and Literature

MeDesign Human Health Book: human anatomy diagrams with sleek new look

MeDesign Human Health Book: human anatomy diagrams with sleek new look


HumanHealth-FIN-16-May-2013-1_Page_01

For many people, the topic of human anatomy evokes feelings of both marvel and dismay. The workings of the body may be a wonder to behold, but their intricacies can be a pain to sort out, remember and explain.

To make human anatomy easier to learn and understand, Bruce Ian Meader, an associate professor at the Rochester Institute of Technology’s Vignelli Center for Design Studies, and his class of 13 first-year graduate students tackled the task of streamlining diagrams of human anatomy in 2014 as part of the School’s Medicine+Design initiative.

For this assignment, the class was given 10 weeks to design several short book chapters that explain systems of the human body for a general audience. To accomplish the task, the class split into small groups to research, write, and design simplified layouts of body systems, such as the brain, eyes, joints and nervous system. Once the book chapters were complete, the students worked together to assemble the chapters into a book they called the MeDesign Human Health Book.

The book is already earning praise and has sparked a second phase for the Medicine+Design initiative in 2015. You can view the entire book online for free at the school’s website.

Previously: University of Glasgow medical student makes learning anatomy a feast for the sensesImage of the Week: A playful take on the human respiratory systemImage of the Week: VeggieanatomyImage of the Week: Quilled anatomyKitchen anatomy: Brain carved from a watermelon
Via Street Anatomy
Artwork courtesy of Bruce Ian Meader and artist Cai Jai

Medical Education, Medical Schools, Mental Health, Stanford News

A call to action to improve balance and reduce stress in the lives of resident physicians

A call to action to improve balance and reduce stress in the lives of resident physicians

4086639111_a7e7a56912_zIn November of 2010, those in Stanford’s general surgery training program experienced an indescribable loss when a recently graduated surgical resident, Greg Feldman, MD, committed suicide. His death wound up being a call to action that brought about the Balance in Life program at Stanford, according to program founder Ralph S. Greco, MD.

With the Balance in Life program now in its fourth year, Greco; chief surgical resident Arghavan Salles, MD, PhD; and general surgery resident Cara A. Liebert, MD, have learned much about the daily stresses that resident physicians face. In a recent published JAMA Surgery opinion piece they wrote:

As physicians, we spend a significant amount of time counseling our patients on how to live healthier lives. Ironically, as trainees and practicing physicians, we often do not prioritize our own physical and psychological health.

A recent national survey found that 40% of surgeons were burnt out and that 30% had symptoms of depression. Another study reported that 6% of surgeons experienced suicidal ideation in the preceding 12 months. Perhaps most startling, there are roughly 300 to 400 physicians who die by suicide per year—the equivalent of 3 medical school graduating classes.

Greco, Salles and Liebert explain that the Balance in Life program is specifically designed to help resident physicians cope with these stresses by addressing the well-being of their professional, physical, psychological and social lives. To accomplish this goal, the program offers mentorship and leadership training activities; dining and health-care options that are tailored to the residents’ busy schedules and needs; confidential meetings with an expert psychologist; and social events and outdoor activities that foster support among residents.

The authors concede that the program may not fix every stressful problem that their residents face, but it does let the residents know that their well-being is important and valued. “This may be the most profound, albeit intangible, contribution of Balance in Life,” the authors write.

Although the program (and the JAMA article) is geared for people in the medical field, it’s not much of a stretch to see how its core principles can apply to any work setting. Learning how to manage stress and reach out to colleagues for support is a valuable skill and, as the authors write, to provide expert care for others you must first take good care of yourself.

Previously: After work, a Stanford surgeon brings stones to lifeSurgeon offers his perspective on balancing life and workProgram for residents reflects “massive change” in surgeon mentality, New surgeons take time out for mental health and Helping those in academic medicine to both “work and live well”
Photo by Gabriel S. Delgado C.

Medical Education, Medical Schools, Mental Health, SMS Unplugged

Free from school

Free from school

SMS (“Stanford Medical School”) Unplugged is a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week; the entire blog series can be found in the SMS Unplugged category

Editor’s note: After today, SMS Unplugged will be on a limited publishing schedule until September.

girls running

Summer. It beckons with strawberry warm rays of sunlight, afternoons spent splashing in a pool, and the joys of watermelon-flavored popsicles. We, second-year medical students around the country, look out our windows and see children, newly freed from school, frolicking in the playground next door – and feel miserable. For this is the time when we are experiencing the worst of medical school.

We have completed the pre-clinical curriculum, some of us barely crawling across the finish line. We have spent weeks cramming for the USMLE, an exam described in no softer terms than “the most important exam you will take in your life.” And we are becoming familiar with a new kind of anxiety as we prepare to enter clinics for the first time. Or, rather, my classmates are – I chose to take time off between second and third year.

In the midst of Stanford-high expectations for our professional performance, we are seldom taught exactly how to take care of ourselves. I knew that I needed to change something halfway through second year when I found myself outlining a novel instead of studying during finals week. I nearly failed two exams. But I was happy.

I felt satisfied.

And so, I set about finding a way to incorporate more of writing into my medical school experience. Stanford has funding called Medical Scholars, which is set aside for every medical student to take a year off to work on a significant project or research experience. Their office willingly helped me apply for and receive this funding to work on my novel full-time for a year. I can’t imagine this level of support for an artistic endeavor from any other medical school. And so very soon, I too will be frolicking in the grass, newly freed from school.

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