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Events, Medical Education, Medical Schools, Pediatrics, SMS Unplugged

A Match made at Stanford: From medical student to resident

A Match made at Stanford: From medical student to resident

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.

IMG_1127On March 20, in synchrony with thousands of senior medical students across the country, I received an envelope that determined where I would be spending the next three years of my life for residency training.

My academic advisor, Oscar Salvatierra, MD, had come out of retirement to share this day with his students. He had supported us over the years, from studying for our first-year exams to choosing a specialty and applying to residency. He supported my husband and me in the additional challenges of tackling medical school as a married couple, guided us through my husband’s decision to pursue a combined MD/PhD degree, and even weighed in on our decision to have a child during medical school. Now, on Match Day, I was so grateful that he was the one to call my name and hand me my letter.

“Open. Open. Open,” my daughter demanded, grasping for the bright red envelope with the same steady persistence that she normally uses to ask for raisins. My husband took her from my arms so that my shaking fingers were free to open the envelope and unfold the letter. It was real, right there in black and white: I’ll be staying at Stanford for a pediatrics residency.

I grinned, then I cried, then I started soaking in the hugs and congratulations of my family, friends, and mentors who all knew how desperately I had hoped for this outcome. But the fun part about Match Day is that there is more than just your own news to celebrate. Within minutes, I was fighting through the crowds to track down my friends and classmates to find out where they had matched. I was incredibly impressed, but not at all surprised, to hear about the excellent programs they will be attending across the country.

As I stepped back into my apartment later that morning, clutching my residency Match letter, it felt a lot like bringing a newborn baby home from the hospital: it was odd and unsettling to walk back through familiar doors into my familiar home when our family’s life was all at once so deeply changed. In residency (like becoming a parent), I am going to have to work harder than I’ve ever worked before, and be challenged in ways I haven’t even imagined. But at the same time, I have no doubt that it will be worth it, and that this was exactly what I want for my life.

I hope that my classmates are feeling the same excitement to start the next phase of the journey. Congratulations to the Stanford Medicine Class of 2015 on an incredible Match!

Jennifer DeCoste-Lopez is a final-year Stanford medical student who will soon start a residency in pediatrics at Stanford. She was born and raised in Kentucky and went to college at Harvard. She currently splits her time between clinical rotations, developing a new curriculum in end-of-life care, and caring for her young daughter.

Photo courtesy of Jennifer DeCoste-Lopez

Events, Medical Education, Medical Schools, Medicine X, Stanford News, Technology

Registration now open for the inaugural Stanford Medicine X|ED conference

Registration now open for the inaugural Stanford Medicine X|ED conference

15168705662_f658f6aa3a_zSome exciting news for those who have followed our Medicine X coverage in the past or who have attended the popular event in person: The first-ever Stanford Medicine X|ED conference will be held on campus this fall. The two-day event, scheduled for Sept. 23-24, will bring together innovative thinkers to explore the role of technology and networked intelligence in shaping the future of medical education.

Lawrence Chu, MD, associate professor of anesthesia at the School of Medicine and executive director of Medicine X, explained in a release that he launched the conference because “changing the culture of health care starts with redefining medical education.” He hopes the gathering will “address gaps in medical education to drive innovation and make health care more participatory, patient centered and responsive.”

Digital media pioneer Howard Rheingold will kick off the conference with a keynote address, with the rest of the first day of the conference focusing on five core themes, including engaging millennial learners, opportunities and challenges for innovation in medical education, interdisciplinary learning, and how digital media and massive open online courses are redefining the educational landscape. Abraham Verghese, MD, vice chair for the theory and practice of medicine for Stanford’s Department of Medicine, will deliver the closing keynote.

Day two of the program will include a range of interactive and educational opportunities, as I describe in our release:

The conference will offer tutorial-style classes called “learning labs” on topics such as incorporating instructional technologies into curricula, and using social media to promote patient safety. Additionally, attendees can participate in 90-minute workshops on using 3D printing in medical education, interprofessional care models and methods for bringing real patients’ stories into medical education.

Conference-goers can also enroll in master classes where experts in specific disciplines will conduct small-venue seminars. Confirmed master-class speakers include [Lloyd B. Minor, MD, dean of the School of Medicine]; Bryan Vartabedian, MD, assistant professor of pediatrics and director of digital literacy at the Baylor College of Medicine; Bertalan Meskó, MD, founder of Webicina; and Kirsten Ostherr, PhD, professor of English at Rice University and director of the Medical Futures Lab.

“Health care has changed dramatically in recent years, but the way we teach the next generation of doctors has largely remained the same,” Minor commented. “Stanford Medicine X|ED brings together some of the most innovative minds in medicine, technology and education to re-imagine medical education for the new millennium.”

Registration details can be found on the conference website. Medicine X, Stanford’s premier conference on emerging health-care technology and patient-centered medicine, will kick off the day after Medicine X|ED.

More news about Stanford Medicine X is available in the Medicine X category.

Previously: Stanford Medicine X: From an “annual meeting to a global movement” and Medicine X aims to “fill the gaps” in medical education
Photo of Chu by Stanford Medicine X

Medical Education, Medical Schools, Stanford News, Surgery

After work, a Stanford surgeon brings stones to life

After work, a Stanford surgeon brings stones to life

MA15_Profs_Greco_480pxClassrooms, research, grant writing, faculty meetings… It can be easy to forget that professors have a life outside of the classroom, perhaps with surprising hobbies and talents. The new issue of Stanford Magazine highlights the extra-professional lives of some of the university’s extraordinary professors, including Ralph Greco, MD.

Greco is a sculptor of stone as well as a surgeon. His work decorates his home and has sold for as much as $8,500. Perhaps his most notable sculpture is the abstract “S” that graces the Department of Surgery. He created the work of art from a 400-pound marble boulder that was gifted to him at a graduation dinner when he was the director of the general surgery residency program.

It’s perhaps not surprising that the multi-faceted Greco is an advocate for work-life balance among surgeons. He established a support program after the suicide of a surgical resident, and because he says sculpting can be “too self centered,” he pursues other interests as well. Check out the article to learn more.

Previously: Program for residents reflects “massive change” in surgeon mentality and New surgeons take time out for mental health
Photo by Nicolo Sertorio

In the News, Medical Education, Medical Schools, Research, SMS Unplugged

Research in medical school: The need to align incentives with value

Research in medical school: The need to align incentives with value

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.

7336836234_05b7e59045_zIt is a truism of American medical education that students should do research. Stanford medical school’s website espouses a “strong commitment to student research,” because it makes us “valued members of any medical field.” A similar message can be found at almost any other institution. It’s not just medical school either. Many undergraduate programs tout their research offerings for pre-medstudents, while residencies and fellowships often encourage their trainees to pursue investigatory projects.

There are several reasons for the emphasis on research in medical training. One obvious explanation is that schools want to prepare students for a career in academic medicine, through which physicians can combine scientific discovery with clinical insight to drive medicine forward. More broadly speaking, research is a way to develop analytic and critical thinking skills. These abilities not only help students better understand disease – they teach us how to read and interpret scientific literature to keep up to date with the latest advances in the field.

I believe in the value of engaging in research, but I recently came across the work of two prominent academic physicians who question whether it accomplishes these goals. The first is Ezekiel Emanuel. While he may be best known for his work on the Affordable Care Act as a special advisor to the White House, Emanuel’s background is in academics. After completing an MD/PhD at Harvard, he stayed on as an associate professor; he’s now a vice provost and professor at the University of Pennsylvania.

In his book, Reinventing American Health Care, Emanuel discusses how to make medical education more effective, and he specifically targets the research paradigm as an inefficiency. Whether or not it is explicitly stated, many top-tier programs require their students to do research in addition to their clinical training. To Emanuel, this constitutes “exploitation of trainees for no improvement in clinical skills.” He argues that eliminating such requirements can streamline medical education and boost the physician workforce. The physician shortage is one of the most discussed problems in health care. Trimming the length and cost of training can help address it. Reducing research requirements would allow students to prioritize their clinical work or other relevant interests.

“Exploitation” is perhaps an overstatement, but Emanuel addresses a legitimate concern about whether students’ time is best spent on research. And findings from researchers like Stanford’s John Ioannidis, MD, amplify the concern.

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Events, In the News, Medical Education, Medical Schools, Stanford News

Match Day at Stanford sizzles with successful matches & good cheer

Match Day at Stanford sizzles with successful matches & good cheer

Rowza Rumma, hugs Jennifer DeCoste-Lopez, at Match Day 2015 at Stanford School of Medicine on March 20, 2015. ( Norbert von der Groeben/Stanford School of Medicine )Across the country at the exact same time — 9 AM in California — on the third Friday in March, graduating medical students assemble for Match Day, the day they receive their assignments to residencies.

It’s a spectacle — a cross between a graduation celebration replete with champagne and balloons and a theater audition with tears and heartbreak. The Stanford students, no surprise, are top-notch, so there were more grins than groans and plenty of congratulations and good cheer for all.

The stats themselves stand out: 77 students were matched Friday and they’re heading to 14 states, with California and Massachusetts leading the list. (A map showing where everyone is headed is below.) General medicine is the most popular specialty, followed by anesthesia, neurosurgery and pediatrics. No Stanford students were matched in urology, radiology and psychiatry.

Before the event, I checked in with two graduating students, Mia Kanak and Rowza Tur Rumma. Both are accomplished health professionals with interesting backgrounds and plans to make the world a better place. Kanak is a Tokyo native who hopes to help impoverished children. Rumma wants to translate the success of the world’s best operating rooms into practices that work in the poorest nations.

As I wrote in a story:

For [Rumma], the day was both exciting and nerve-wracking. “I think it’s hard to not have the jambalaya of those issues in our minds,” she said. Clutching the red envelope and a cell phone, she was dialing repeatedly, trying to get in touch with her parents in Bangladesh to share the moment with them.

Finally, her father on the phone, Rumma slit open the envelope, a relieved grin spreading across her face. “It’s Brigham,” she said, her first choice. Brigham and Women’s Hospital offers opportunities for its surgical residents to specialize in global health, just the program Tur Rumma was hoping for. For the residency, she was interviewed by Atul Gawande, the well-known author and surgeon, and was able to discuss her work during a summer program in Bangladesh, where she worked to implement — and adapt — a checklist of steps to reduce surgical complications adopted by the World Health Organization.

Kanak also secured her first choice, a berth in the Boston Children’s Hospital‘s pediatrics program.

“I want to say how proud all of us at Stanford Medicine are of your accomplishments today,” Dean Lloyd Minor, MD, told the group after envelopes had been torn open. “And now, on behalf of everyone, a toast to your success, to the impact you’re going to have on the lives of so many people moving forward: Best wishes!”

View Stanford Residency Match Day 2015 in a full screen map

Previously: Stanford Medicine’s Match Day, in pictures, It’s Match Day: Good luck, medical students!, At Match Day 2014, Stanford med students take first steps as residents and Image of the Week: Match Day 2012
Photo of Rowza Tur Rumma by Norbert von der Groeben; map by Kris Newby

Medical Education, Medical Schools, Stanford News

It’s Match Day: Good luck, medical students!

It's Match Day: Good luck, medical students!

MatchDay14-

Updated 2 PM: A sampling of photos from today’s event can be found here.

***

7:30 AM: Today, small envelopes containing big news will be handed out to medical students at Stanford, and those at 155 medical schools across the country, as they gather to learn where they’ll spend the next three to seven years during their hospital residencies. We wish students at Stanford and around the country the best of luck!

The annual rite of passage for doctors-to-be is known as Match Day and is the culmination of the endless hours of hard work, countless nights of studying, years of college and grueling interviews. Residency assignments are determined by the National Resident Matching Program, a nonprofit organization that was created in 1952 at the encouragement of medical students to establish an orderly and fair mechanism for matching the preferences of applicants for residency positions in the United States with the preferences of program directors. The organization uses a computer algorithm to align the choices of students with those of the residency programs.

My colleague Becky Bach will be joining students this morning on the Stanford campus to capture the ceremony and excitement. Watch for photos and details from the festivities here, and on @StanfordMed and the medical school’s Facebook page.

Previously: At Match Day 2014, Stanford med students take first steps as residents, Image of the Week: Match Day 2013 and Match Day 2012 decides medical students’ next steps
Photo by Norbert von der Groeben

Medical Education, Medical Schools, Medicine and Society, Stanford News

Engaging with art to improve clinical skills

Engaging with art to improve clinical skills

med students looking at paintingThe scene: A group of medical students huddled around the iconic Robert Frank photograph Car Accident – U.S. 66, Between Winslow and Flagstaff, Arizona in the Cantor Center for the Visual Arts. They’re being led through an observation exercise by Sarah Naftalis, a doctoral student in art and art history at Stanford, as part of an innovative new medical school course supported by the Bioethics and Medical Humanities Scholarly Concentration.

Naftalis asks students what they see as she gestures to the photograph, which appears to have as its focal point four people standing out in a field, looking at something under a blanket on the ground. Several students note the people, the odd lumpiness of the blanket and the reduced horizon. Second year medical student Sam Cartmell says, “Well there may be more than four people,” and points to an odd contour at the shoulder of the lone female in the photograph. Cartmell’s observation sparks a lively debate, as his fellow students take turns looking closely at the work, seeking to discern what Cartmell has seen.

The concept behind this class is so important. If medical students can grasp these observation skills, it will really serve them well in their residencies and beyond.

That moment, explains Naftalis, illustrates the “productive ambiguities of art,” as well as the benefit of engaged close looking without “rushing to assign meaning to what we see.”

The practice of engaged close looking as a means to improve observational skills is a key goal of the course, which includes gallery sessions facilitated by doctoral students from the Department of Art and Art History at Stanford paired with a clinical correlate hour where School of Medicine faculty members applied the lessons of the art gallery portion to the clinical setting. Physicians from family medicine, orthopedics, dermatology, pathology and anesthesiology led discussions on a range of topics including narrative, body in motion, skin and tone, and death.

“The thematic organization was meant to inspire conversation across disciplines, by putting two takes on a similar theme in proximity to each other for two hours,” explains art history doctoral student Yinshi Lerman-Tan, who helped develop the course. “Bringing medicine into the space of the museum was a great aspect of the course – simply allowing different bodies of knowledge to exist under one roof. The medical students would sometimes use clinical vocabulary or concepts to describe works in the gallery, making for an interesting range of language in our discussions.”

Cartmell said one important take away for him from the course, which is called “The Art of Observation: Enhancing Clinical Skills Through Visual Analysis,” was learning to observe without jumping to interpretation. “I was surprised at how strong the impulse was to interpret the work, before I had actually observed the entire piece,” he says. The exercises the instructors led us through, describing what we saw objectively without commentary, really forced me to slow down and really see what was in front of me, without jumping to conclusions or interpretation.”

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LGBT, Medical Education, Medical Schools, Research, Stanford News

Stanford study shows many LGBT med students stay in the closet

Stanford study shows many LGBT med students stay in the closet

doctor by rainbow flagFears of discrimination from faculty, peers and patients continue to pressure many in the lesbian, gay, bisexual and transgender community to stay “in the closet” while in medical school, according to a Stanford study published today in Academic Medicine.

Some medical students worry that “coming out” could affect their grades; others are influenced by homophobic or sexist remarks overheard from peers and faculty to keep their sexual or gender identity hidden, according to the results of an online survey sent by the study’s authors to medical students throughout the U.S. and Canada. One respondent recounted an appointment during a surgery rotation with a transgender patient who was “treated like a freak by the residents and attendings behind closed doors, joking at his expense.”

The study, authored by members of the Stanford Lesbian, Gay, Bisexual & Transgender Medical Education Research Group, was accompanied by a commentary that maintains the medical community is less accepting of sexual and gender minorities than the business or law communities. From a press release I wrote on the study:

“There is still this huge percentage of medical students who are afraid of discrimination in medical school and how it could affect the rest of their careers,” said Mitchell Lunn, MD, a co-author of both papers and co-founder of Stanford’s LGBT research group. “We are supposed to be a field that is accepting of people and one that takes care of people regardless of differences, and yet we can’t even do that for people who are part of our own community.”

The study found that a third of sexual minority medical students choose to remain “in the closet” during medical school, 40 percent of medical students who identify as “not heterosexual” are afraid of discrimination in medical school, and two-thirds of gender minority medical students (those identifying as something other than male or female) conceal their gender identity during medical school.

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Events, Medical Education, Medical Schools, Stanford News, Videos

What’s it like to be an internal medicine resident at Stanford?

What's it like to be an internal medicine resident at Stanford?

“I remember being in your shoes,” Ronald Witteles, MD, said to prospective residents during a recent Google+ Hangout sponsored by the Stanford Internal Medicine Residency program. “I really felt that Stanford was the best fit for me, so I crossed my fingers and came out here. It’s been everything I hoped it could be and more.”

Witteles is the resident program director, and he joined a panel of faculty, residents, and physicians to share stories and answer questions from prospective residents and the interested public about life at Stanford.

During the Hangout, department chair Robert Harrington, MD, spent time discussing Stanford’s tradition of innovation – highlighting the Biodesign program, a collaboration between the School of Medicine and the School of Engineering, and the Department of Medicine’s Clinical Excellence Research Center, which organizes research teams to discover and design new methods of health-care delivery. When asked to comment on the school’s innovative reputation, he replied: “There is a spirit of innovation across the residency, across the department, and across the university that I think is unique, and is one of our defining characteristics.”

Several programmatic changes were also addressed during the hour-long conversation. Witteles talked about a new initiative called Pathways of Distinction, or POD, which will allow residents to select one of seven individualized pathways that align with their academic and professional interests. Each POD, he explained, will provide residents with a unique opportunity for mentorship and development outside of their primary education in internal medicine.

Additional audience questions ranged from the level of autonomy afforded to residents (the answer: a significant amount, but you’re never left by yourself), to favorite things about Palo Alto, which garnered enthusiastic group consensus about the vibrant food scene and the close proximity to nature. Watch the full conversation above.

Previously: Stanford Internal Medicine Residency program to host Google+ Hangout

Events, Medical Education, Medical Schools, Stanford News

Stanford Internal Medicine Residency program to host Google+ Hangout

Stanford Internal Medicine Residency program to host Google+ Hangout

Are you interested in internal medicine? Or wondering what doing a Stanford residency is like? Then join Stanford’s Internal Medicine Residency program tomorrow for a Google+ Hangout, where program leadership will talk about the current landscape of internal medicine, share program highlights and answer your questions.

During the discussion, you’ll meet faculty and physicians who are transforming the field of internal medicine. You’ll also hear from current and former residents who will reflect on their experiences at Stanford. Ronald Witteles, MD, assistant professor and director of Stanford’s residency program, will moderate the conversation. Other panelists include:

  • Robert Harrington, MD, chair of the department of medicine
  • Abraham Verghese, MD, physician and vice chair of education
  • Neera Ahuja, MD, associate professor and associate director of Stanford’s residency program
  • Wendy Caceres, MD, clinical instructor and former resident
  • Jim Boonyaratanakornkit, MD, chief resident
  • Kathryn Weaver, current resident

The discussion begins at 1:30 PM Pacific Time. Visit this page to participate in the hangout.

Lindsey Baker is the communications manager for Stanford’s Department of Medicine.

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