The Inspirational Power Celebrities Have on Patients

Posted in Robert Spencer '15 on November 11th, 2013 by mars02 – Be the first to comment

This article was originally posted on KevinMD.com

 

By Robert Spencer

I will never forget my first Kenny G concert. It was in the fall of 1994, just a few weeks after I had undergone my second eye surgery, which I had needed to repair my cranial nerve palsy. By that time, I’d already suffered through five other operations from the neck up, and in my seven-year-old mind, I had somehow convinced myself that I was never going to be “normal” like other children my age. Unlike them, I would be coping with neurological issues and requiring invasive surgeries all my life. Eager to boost my spirits, my mother surprised me with two tickets to see a performance by my favorite musician.

The concert took place at what is now the PNC Bank Arts Center, a large amphitheater in Holmdel Township, NJ. We arrived two hours early, and I still remember standing at the venue’s ticket window and watching my mother pick up a long white envelope, which she handed over and instructed me to open. I was stunned at what I discovered inside.

Not only were there two Kenny G tickets, but also two adhesive backstage passes. I could feel my heart pounding inside my chest. “Are these really for us?” I exclaimed.

“Kenny wants to meet you,” my mother said, delighted by my enormous grin.

An hour later, I found myself sitting backstage with my hero, Kenny G. There we were, the two of us in a private room brimming with brass musical instruments. With tears in my eyes, I remember telling Kenny how I had listened to his music during several of my hospitalizations, how it had a magical way of making me feel better. I’ll never forget him telling me that I needed to stay strong.

“I will,” I promised him. He gave me a tour of his instruments, starting with his alto saxophone, and for a few minutes he even played a beautiful melody just for me. In that moment, I felt like the luckiest kid in the world.

It’s a funny thing how celebrities have the power to restore hope, strength, and joy in young patients who are going through difficult times. Two decades have passed since I first met Kenny G, yet I still remember every word of our conversation, and I continue to think about that concert frequently.

While I have yet to figure out how exactly my mother arranged for me to meet Kenny, I consider myself extremely lucky to have had the opportunity, especially in that particularly dark moment of my childhood. Not long ago, I found an opportunity to pay my good fortune forward to another young man struggling with a difficult post-operative recovery.

In my first month of medical school, now almost two years ago, I met a sixteen-year-old patient named Ryan who had recently undergone the surgical resection of a brain tumor. It was Halloween, and I had been volunteering with classmates on the pediatric unit, walking from room-to-room with bags full of sweets. Towards the end of the evening, we found ourselves standing at the foot of Ryan’s bed, where he lay motionless with gauze wrapped firmly around his head. His upper extremities were weak, and his right pupil deviated to the side as he attempted to focus his eyes on me. His mother lowered the volume on the television so we could hear each other over the Knicks game.

What ensued was a lengthy conversation about the Knicks, which was Ryan’s favorite basketball team. Soon I learned that his idol was the team’s forward, Carmelo Anthony (a.k.a. “Melo”). Ryan knew Carmelo’s background and stats like the back of his hand, telling me that he had played for Syracuse University and led the team to their first national championship in 2003, how he had then played with the Denver Nuggets and become an NBA all-star, and how in 2008 he brought home an Olympic gold medal from Beijing.

I was so intrigued by what I had heard about this basketball sensation that later, once I arrived home, I couldn’t help but Google him. Within minutes, I was reading basketball forums that described the all-star as “generous” and “kindhearted.” A fan wrote, “One time he stayed after a game to sign autographs, and when it was my turn, he ran out of ink, so he gave me his headband.” It was clear Carmelo had an unassuming manner and benevolent spirit, so I began scavenging the Internet for the “right” contacts in case he might be willing to do something nice for Ryan. Several hours later, I managed to deliver a message to his representatives, explaining how grateful I would be if Carmelo could sign an autograph for one of his young fans in the hospital.

No response came at first, but eventually I received an email from a woman who was no longer working with Carmelo. She was, however, willing to forward my plea to his agent. “I’d appreciate that,” I wrote back.

On a rainy morning in November 2011, a tall woman dressed in dark jeans, a black coat, and a black scarf met me in the hospital lobby. A child life specialist and three classmates rounded out the entourage. I thanked her for coming, and we proceeded upstairs and knocked on the door of room 937. “Ryan?”

His parents welcomed us into the room. We approached his bedside and the tall woman introduced herself as Carmelo’s friend. “He heard you’re a devoted fan and wanted to do something special for you,” she said, presenting Ryan with an autographed basketball and Knicks hat. Ryan’s face lit up like a Christmas tree with his first smile in weeks.

Then the woman’s cellphone began to vibrate. She flipped it open, handing it to Ryan. “Someone wants to talk to you,” she said as we all stepped out of the room, leaving Ryan to speak with his hero.

When we returned, Ryan was elated. “Carmelo promised to pray for me,” he beamed.

That phone call had a big impact on Ryan’s spirit. He thanked me effusively each time I visited him over the following months, full of smiles and vitality. There is something profound about having an encounter with your celebrity idol. When someone you’ve admired and grown to feel like you know on a personal level takes an interest in you, you feel as if you are as special and singular as they are, even if only for a moment. Through my own experience and through watching Ryan’s, I know that such moments are so powerful that they last far beyond the encounter.

I happened to meet Kenny G again last year before his performance at the Blue Note jazz club in Manhattan. As I entered the quaint venue, eager to watch him perform his soothing tones, I noticed him signing autographs for some fans. I walked up to Kenny and re-introduced myself, reminding him of our encounter in 1994. He smiled and told me he remembered the interaction well—that he recalled me wearing sunglasses because I was still sensitive to light after my surgery. I couldn’t believe it.

We chatted for a few minutes, and I told him I was now in medical school, often meeting children in dire situations. I told him how a celebrity icon interaction for a particular child could make all of the difference in that child’s outlook on life.

The positive energy that comes from such an encounter can have a surprising impact on one’s health. Modern medicine, powerful as it is, can achieve only so much. When a child has the opportunity to communicate with someone they idolize, they feel more connected to the world—at the same time as they feel uplifted by the encounter, they also realize that no one is superhuman. Experiencing celebrities as just the same as everyone else, including themselves, is grounding and comforting. Such interactions can give patients a renewed sense of faith in recovery and a brighter outlook on life, and although I can’t prove it, I’m almost positive that this attitude can improve recovery time.

Of course, not all young patients get the chance to meet their celebrity favorites. Still, it behooves us to try to make these types of encounters possible. Just as I figured out how to help Ryan, we all have the power to at least try to make these dreams come true.

Perhaps you cannot arrange to get a child’s hero in the same room. What would be the next best thing? What can you do to make a child’s world more promising than he or she presently perceives it to be? You’d be amazed what wonders you can achieve for others with a resourceful imagination, and how such wonders can truly lift lives.

How to Get “Into” Medical School: 5 Tips for Surviving the First Semester of Medical School

Posted in Student Life on September 13th, 2013 by mars02 – Be the first to comment

By Courtney Toombs

You’re in! Congratulations! It’s finally over!

Yeah – not so fast. You survived getting into medical school but now you have to face the prospect of actually starting. Perhaps you were so exhausted by the application process that you took the entire summer off to travel through South East Asia, party with college friends or just sleep all day. Maybe you continued working to save money or just moved your whole life from the last place to this place. Hopefully you weren’t thinking about medical school this summer and were just enjoying the accomplishment and excitement about the future. But now the alarm clock is going off and it’s time to go back to school. What do you need to know to get through the first semester successfully?

I am going to give you the top 5 tips for getting “into” medical school, meaning how to actually find your way in the first few months of medical school. Hopefully these tips will also speak to those on the verge of applying and give them some perspective about why they are writing the same essay six slightly different ways for six different schools or why the MCAT suddenly took away the section that was a bonafide hour long break (to the essay, we humanities majors will miss you).

Tip #1: Meet Your Classmates

Perhaps you have been living under a rock since you decided to start pre-med, avoiding all distracting social interactions to a point that eventually you stopped being invited to events because “you never come anyway” or “we didn’t want to make you feel left out since you are always studying.” Well now is your chance to throw off that mantle and dive into meeting your classmates and making new friends. Everyone at medical school will have a lot in common with you and even if you don’t get along with or like everyone, you should respect them for the amount of hard work, dedication and character they have displayed just to share a seat with you in class. In the first few weeks meet as many people as possible and introduce yourself to everyone no matter how awkward it might be to approach new people. In many ways the first few weeks feel like frosh week in college, but fortunately most people in med school are not looking to social climb or form exclusive groups. Meet upperclassmen when possible as well; they have invaluable advice on all aspects of school and keep you looking forward to the next step. If you do not live on campus or in the area where most of your classmates live, make an effort to meet up with everyone on their turf or suggest hanging out in your area. Do not exclude yourself for any reason, be it geography, relationship status, age or background! Everyone at medical school wants to make new friends and make up for all those lost hours studying, just like you!

Tip #2: Explore Your New Home

NYU is in the heart of New York City, my hometown. Therefore I was very familiar with the city before starting medical school, however many of my classmates were not and found the adjustment a bit difficult. During the interview season you may feel like a celebrity on a world tour, rushing from place to place making appearances and doing interviews, all while never actually seeing the places you are visiting but merely passing through. Especially in a big city like New York, it takes more than one campus tour or even a few days surrounding your interview to explore the city and figure out how you are going to live in this new environment. I believe it is always best to live on campus when possible since this eliminates commuting, allows you 24/7 access to the campus facilities (library, gym, printers, etc) and makes socializing and group studying more convenient. Safety is always a concern and the more time you spend in your new hometown the better you will understand the places and times of day that are safest in your neighborhood. Make sure that before you move into your new apartment you experience the entirety of your new city, maybe even on a few days before orientation dedicated just to acting like a tourist and visiting all the sites, neighborhoods and famous haunts. Whether your school is in a small town or in the greatest city in the world (I’m biased!), you will probably have little time once classes start to find that special Philly cheesesteak stand, independent movie theater or riverfront park. One day you will say to people I lived in X for four years, so you better know X like the back of your hand and learn to love it! You will also benefit tremendously from finding your local creature comforts before classes start: grocery store, laundry, pharmacy, gym, Chinese takeout place, etc. Do not assume that you will explore your new hometown during medical school; academics and extracurriculars add up and you will likely spend more time in the library and hospital than you ever do about town.

Tip #3: Respect the Process

You’re here! At the gates of your hopes and dreams! You are a doctor…well not quite. You have a ways to go before you really could call yourself a doctor and in the meantime you basically will be at the bottom of the medical hierarchy. Facing this reality can be difficult since, more than anything, you want to jump straight in to treating patients. Depending on how your school’s curriculum is structured, some students may immediately start with anatomy, others with the basic biological science foundations and even others with immediate patient interaction. At NYU we spend the first few months on the basic sciences (Biochemistry, Cell Biology, Genetics, Viruses, etc) before we begin anatomy and the “systems.” For some students, especially non-science majors, postbaccs (like me) and those more than 1 year out of school, these few months can be demoralizing. “I didn’t come to medical school to learn the name of every factor, protein and receptor in the human cell, I came to learn medicine!!” Well, unfortunately those basics are the foundations of medicine and without them you could not claim to truly understand macro concepts. Respect and embrace how your school has chosen to teach you the material. Don’t fight the process if it doesn’t appeal to you, just find something else at school that you enjoy studying or doing until a new module or block starts that you jive with more. Talk to your classmates; some of them probably feel much the same way as everyone is arriving with different backgrounds, interests and academic strengths. You will all sync up eventually when you start learning material that no one has studied before, or when you start interacting more with patients, with which many people have less experience.

Tip #4: Be Confident

Doctors often get a bad rap for having enormous egos or “god-complexes.” Premeds are twice as bad with none of the ground to stand on. But something about starting medical school can really affect your confidence. Maybe it’s the incredible amount of new material, studying and responsibilities thrust upon you, or maybe it’s being surrounded by the brightest minds of your generation. Either way, it can be hard to no longer be the big fish in the small pond or to just feel like the pond is now filled with only genius piranhas. But don’t be nervous and don’t get down on yourself. In my opinion the quality of any educational institution is above all dependent on the composition of its students. The smarter, more accomplished, and more interesting your classmates are, the better the school you attend. Count yourself lucky if your classmates intimidate you and remind yourself that the admissions committee decided that you are also intelligent, accomplished and interesting, but perhaps in ways different from your classmates. Take advantage of what your friends know and give them something to be jealous of as well. This is not premed, everyone can do well in medical school and everyone will get a residency. Work together will your classmates and you will be much happier and more prepared for working in medicine.

Tip # 5: Take Care of Yourself

Yes, you must take medical school very seriously as it will be difficult and overwhelming at times. But you also can’t run yourself into the ground just to get everything done. You must stop and do things for yourself that have nothing to do with medical school. See your family and outside friends, work out, watch TV, cook or play with a dog. Do something that doesn’t make you stressed out! Eventually you will run out of time to sleep a lot, so if you like to sleep, take your naps now and appreciate them. Take some time to reflect on your existential thoughts; time will begin to fly by and you will wish that you grasped that moment to people-watch or read a good book. If working, studying, and all that stress sort of fills your soul and makes you tick, then that’s great but you must still take some time off! You need to get some perspective now and again.  If you never leave the world of medical school you will begin to become that arrogant, isolated doctor who can’t pay attention to anyone or anything except work because nothing else seems as important. Don’t lose who you are in this process – your spirit is what will keep you going when everything else feels too difficult.

Courtney is a member of the NYU SOM Class of 2017.

 

Medical Students: How to Survive the 21st Century Medical School

Posted in Maureen Miller c/o '13 on August 5th, 2013 by mars02 – Be the first to comment

This article was originally posted on KevinMD.com

By Maureen Miller

Congratulations on your admission to medical school! Your white coat ceremony is coming, and it’ll be grand. Your orientation leaders will suggest study skills, where to find scrubs and the best cheap supplements. Maybe more enlightened members of the faculty will remind you that medicine is really about the patients. If your parents are physicians, as so many medical students’ parents are—mine are not—they will reminisce about their own days before work hours restrictions and social mores constrictionTheir manual, The House of God is a great book—and its medical training model no longer exists.

As the pediatrician Don Berwick, former director of the Center for Medicaid Services director and current candidate for governor of Massachusetts, said to the Harvard Medical School class of 2012, today’s medical training is so much like The House of God that it’s actually worse than that described in The House of God—and he went to medical school with the guy who wrote it! So don’t let advice-givers cute up medical school for you. Their proposed skill sets are useless to the 21st century doctor. They grew up in an era free of “skill sets.” Having made it to fourth year with a few skill sets intact, here are my tips for success in a frenetic twenty-first century medical school.

To thine own Internet personal brand be true.  That name spelled backwards on Facebook during residency application season? EsuoH YrogerG, Yerg HtidereM, and nairoD Nhoj? Somebody knows where you are. Own you. House of God guy says he’d have published it under his own name today. Maybe he wouldn’t have selfied the sex scenes or made animated “Oh, no you di’int!” .gif files of patients falling and projectile vomiting, but you get the idea. Personal brand is my favorite slur against millennials. Make it a compliment. It’s hard enough to learn medical professionalism and making yourself act like a parody of a medical student at the same time.

That said, HIPAA is no joke. You will have to complete HIPAA training about once a year. I had a friend who, well, HIPAA should bar me from saying more, but let’s just say more generally that it’s in your best interest not to Instagram yourself in four-point restraints.

While we’re at it, stop quoting doctor shows. You are the hottest doctor show in America right now. Medical school is neither exactly like that show, nor nothing like that show. For any postbaccalaureate premedical students who remember The Larry Sanders Show, medical school is closer to that than it is to any sitcom or hour-long drama. By that, I mean it’s by us and about us. Have you started to notice that the New York Times runs an article on medical education reform at least once a week? C’mon. This is the era of the livestream. You, friend, are the showrunner here. There are articles about you, photos and videos by you, articles and blogposts and tweets written by you, and people older than you will use these words to say you are a 21st century doctor. A classmate will get an article published/be interviewed by a large media outlet/save a life you didn’t/be in the right place at the right time/have a jam band. You aren’t Doc anymore. You’re a health care provider and/or allied professional.

Get used to terrible reviews. Don’t get over them. Do-over them. wrote an eBook about 21st century medical education reform. It got terrible reviews. Some people said I had no idea what I was talking about. Some people thought I was trying to tell other people they had no idea what they were talking about. Mostly I was trying to write an eBook that I felt was true to myself and to my experience. It hurt, but I started taking some of their writing tips as a result. And people thought my writing got better! Take coaching. It feels awful until it feels like flying.

You’ll never forget your first patient—your classmate. During our first group bedside examination, my classmate fainted in front of a senior cardiologist. He saved her, and now she is an internist at his hospital. It was low blood pressure. She was under duress. To her, it felt like being onstage to her, and she froze. I would later come to know that duress well myself, and when I told my classmate about my emotional struggles throughout medical school, a few of them came up to me and said, “You know, I was too! I wish somebody had said something earlier!” Whether hurting or drinking or using, we treat ourselves worse than we treat our patients. We don’t have to cry in one another’s arms, but that not-me person who looks unflappable? Trust me, she’s flipped. Just say so sometimes.

Whenever in doubt, say “online module virtual simulation,” “flipped classroom,” “Google doc,” “back to the bedside,” and/or “big data.” You can also say bench-to-bedside, which encompasses all these ideas and is shorter.

No one knows when/where the test is. Thanks to ongoing medical center renovations and building renamings at my medical school, which is also being renovated, no one ever knew how to find the test. They knew where they were supposed to go during the test that counted (hospital flood). So don’t flip out about what you don’t know. If you have a friend already in medical school, ask if he or she has ever tallied how many times he/she says “sorry” or slumps over in ignorance in one day. My guess: A lot, a lot more than in premed. Someone will show you the way, and you will pass. And on the off-chance you don’t, it will pass.

You will get in trouble for not doing something no one told you to do. Medicine is the best laughter. Thanks to unsynchronized electronic medical records, most medical transfers and transactions occur via electronic platforms. Unfortunately, most hospitals have inconsistent wi-fi and limited computer access. And so you will not know something everyone else knows before they know it. Accept it as occupational hazard. It will be humiliating, but everyone has been humiliated by it at some time. 

You will get in trouble for doing something someone told you to do. Your residents are getting in trouble for sleeping instead of working late at the hospital when they’re not allowed to by law. They are also getting in trouble for working and wanting to sleep. Your attending is getting in trouble for not knowing the fine details of an infinite patient census and for not doing enough teaching, or doing too much teaching. And you will get in trouble for not reading their minds, minds so busy they will forget about whatever they said that made you feel dumb or confused even if you don’t. Are you the last thing on their mind? No, not for most. But they’re busy. Keep in mind that the problem probably isn’t you. It’s systemic, and the system’s not doing so hot. In that vein, cool your heels over these last tips to learn why the system’s as it is and why you came to join it:

Ask where your hospital’s billing office is. Please do not self-inflict a wound in order to get into the ER to do so, but you’d be surprised what people tell you.

Attend a health care reform protest. Now, “health care reform protest” does not mean “Occupy and Tea Party people are crazy.” If you got into medicine to “help people,” then you believe in something, that something being helping people. Most protests are over pretty ordinary issues like nurses and cafeteria workers wanting more respect or stopping a local public hospital from closing. People have a ton to say about American health insurance. Just ask people. Think of it like people asking you for medical advice over Thanksgiving, in reverse.

Ask a family for permission to watch them discuss death. I refuse to say “end-of-life decision-making.” Chronic care management defines health care systems, and illness narratives define people. Other than a morbidity and mortality conference, this is where you see both best.

Spend as much time as you can in an underserved neighborhood. Use the word poor without shame. Watch how much time administrative work takes for residents of the community. Stand with them in line for services. Shop with them. Visit their homes. This is not tourism. It’s practicing medicine.

Play “public health bingo.” As I recently wrote in the Atlantic, medical schools have to give short shrift to topics in preventive medicine to fit in the other learning I wrote about above. Learn the essentials from news briefs or from a card I made for MPH school:

Everyone has read, or is going to read, the same three doctor memoirs. These books are, in order, Mountains Beyond Mountains: The Quest of Paul Farmer, a Man Who Would Cure the World by Tracy Kidder, Complications by Atul Gawande, and My Own Country by Abraham Verghese. I made a checklist of them, for Atul. Off the top of my head, I can name at least ten other physician writers who write with the same verve (Rivka Galchen, Chris Adrian, Austin Ratner, Josh Bazell, Richard Selzer, Arthur Kleinman, Nancy Krieger, Paul Farmer himself), who write more penetrating policy criticism (Arnold Relman, Marcia Angell, Steffie Woolhander and David Himmelstein), three others who write about my teaching hospital alone (Danielle Ofri, Perri Klass, Eric Manheimer).

And every doctor has a start-up project in the works. So you see doctors like to talk about medicine, a lot actually. You wouldn’t be a doctor, either, if you weren’t intoxicated by stories, even if that story is of how a mechanism or a machine works. Even the ones who say they hate reading and books have a screenplay in the drawer. Most of them have a Web start-up in mind, maybe not for now, but — don’t get jealous! Show your work. Share it. Workshop.

Marry that guy. Have that child. Schedule medical school around that, not the other way around. Those are the stories people forget to tell, and they’re usually the best ones. On that note:

It really is about the patients — they’re them, and us.

My best luck to you.

Maureen Miller is a medical student who blogs at doctor writer maureen miller.

 

 

The Business of Being a Doctor: Healthcare Leadership and Administration Fellowship Gives SoM Students Invaluable Experience

Posted in Uncategorized on August 2nd, 2013 by mars02 – Be the first to comment


From left, Dr. Tina Wu and Dr. Rahul Sharma with  Healthcare Leadership and Administration Fellows Sunny Patel and Sonam Jaglan.

This article was originally posted on NYULMC², the internal news site for the NYU Langone community.

In the last several weeks, two about-to-be second-year medical students have had sit-downs with an impressive array of top leadership at NYULMC. They talked about how to lead effectively with chair of the Department of Medicine, Steven Abramson, MD; the economics of healthcare with senior vice president and vice dean for clinical affairs and strategy, Andrew Brotman, MD; root cause analysis with chief medical officer Bob Press, MD; and value based purchasing and the patient experience with senior vice president for patient care and chief nursing officer Kim Glassman, PhD, RN, to name just a few.

How did School of Medicine students Sunny Patel and Sonam Jaglan wrangle valuable time on the calendars of so many senior faculty members and executives? They are the first two students at NYULMC to participate in the Healthcare Leadership and Administration Fellowship, a new summer program aimed at providing invaluable insight into the business and administrative side of their chosen profession.

Offered through the Department of Emergency Medicine under the direction of Rahul Sharma, MD, MBA, medical director and associate chief of service, the fellowship combines clinical shifts in the ED at Bellevue and Urgent Care Center at Tisch, with individual lectures on various topics by a compelling roster of almost two dozen NYULMC physicians, executives, and managers. The fellows also attend regularly scheduled hospital leadership meetings, resulting in broad exposure to emergency medicine, healthcare management, and hospital operations—a rare opportunity for most medical students.

“I remember in one of our first meetings,” says Sonam, “the executive asked us, ‘Do you know how doctors are paid?’ That is such a seemingly simple question, but I didn’t know the answer. It’s something we should know, as medical students.”

Those who are familiar with medical training are aware that it is common for students to pursue fellowships between their first and second years of medical school. Typically, however, the focus is on an area of specialization, with an eye toward choosing a residency. This is the first fellowship at the School of Medicine to incorporate such a strong focus on leadership and administration. Under the sponsorship of Robert Femia, MD, executive vice chair of Emergency Medicine, the fellowship is the brainchild of Dr. Sharma, who graduated from a combined MD-MBA program, and fourth-year emergency medicine resident Tina Wu, MD, MBA, who completed her degrees separately. During his combined degree program, Dr. Sharma noticed this important gap in conventional medical school training. “That was my opportunity to get formal training in business-related topics,” he recalls. “What I found was that unless you were in one of these dual-degree programs, you really didn’t have the opportunity to develop leadership and management skills.”

In that regard, Dr. Wu is unusual. Between her first and second years as a medical student at UCLA, she was one of four summer medical administration fellows there. Her program focused on a specific project, which in her case entailed working with one of the deans at UCLA’s School of Public Health on research into uninsured patients and the resources available to them. “It was a very valuable summer,” she says now. She decided to get her MBA, and also spent a year pursing a global health fellowship in Washington, D.C.

Looking back, she says, “When you’re early in your medical training, these small experiences can make such a large impact on your career,” which for her included sparking an interest in leadership positions. Based in part on her positive experiences, she and Dr. Sharma worked with Dr. Femia and Mel Rosenfeld, PhD, associate dean for medical education, to establish the Healthcare Leadership and Administration Fellowship. Dr. Rosenfeld said of the program, “In today’s healthcare environment, having an MD degree provides students with a myriad of opportunities in addition to patient care. This summer fellowship introduces students to another side of medicine, including operations, patient care quality and safety, outcome metrics, financial performance, and external relationships.”

He continued, “One never knows where the road will lead and I look at Dean Grossman as a perfect example. I would bet that when he was doing his neuroradiology training, the idea of running a business enterprise such as our Medical Center never entered his mind. By exposing our students early in their career to other aspects of the healthcare system, we hope to train the next generation of leaders.”

Our current generation of leaders have also been quick to recognize the importance of such a program, and to lend their time and support. “This program is extremely valuable in today’s healthcare environment,” Dr. Press says. “It is critical for medical students to understand the issues confronting hospital administration and physician leadership during this period of healthcare reform, while seeking to maximize quality and safety of care.” Maxine Simon, chief regulatory officer, remarked that “Introducing medical students early in their training, to the non-clinical complexities and expectations associated with the practice of medicine, helps the student to better understand the importance of systems-based practice. . . . It also provides the students with opportunities to ask the ‘why’ questions about external influences on practice, and analyze how these influences can support physician goals, rather than the physician perceiving these influences as barriers to excellent patient care.”

On a recent morning, the fellows met with members of NYULMC’s Office of Government Affairs, including vice president Gilda Ventresca-Ecroyd, policy analyst Kathleen Bernier, and associate policy analyst Ashley Morrissey. Sunny and Sonam listened and asked questions as Ventresca-Ecroyd elaborated on how the office operates, including developing relationships with elected officials at the city, state, and local levels to help affect change and get legislation passed that stands to have a positive impact on public health and the interests of the School of Medicine and Medical Center.

In one example, the office recently brought a new state assemblyman to NYULMC to meet with Dr. Sharma and representatives from the Department of Population Health to begin forming a coalition to develop new seatbelt legislation for New York State. “To pass legislation—you think, NYU Medical Center is a big place, it should have a lot of pull—but you really need to work in a coalition to get anything done,” Ventresca-Ecroyd explained.

Sunny and Sonam are quick to appreciate the extraordinary insights they’re gaining into so many corners of the Medical Center. While they were nervous in the beginning about some of their two-on-one meetings with Medical Center VIPs, they’ve become much more comfortable. “I think on the first day we were a little more wary,” when they looked at their schedules and saw “HCC 15th floor,” Sonam says. “But they’re all really nice,” she says of the executives they’ve met.” Sunny adds, “Everyone is really friendly.”

There is no debating the value of their summer experiences. “I feel like I’ve learned more in the last three weeks about healthcare and the economics behind it than I have any other way,” says Sonam, while Sunny compares it to a crash-course introduction to an MBA. The last piece is their final projects: Sonam is interviewing department chairs about approaches to healthcare leadership; and Sunny is conducting a quality and safety study aimed at efficient delivery of medication to children in the ED.

Drs. Sharma and Wu hope to expand the program next year, and with good reason. The enthusiasm from the students and faculty involved is infectious. As Dr. Sharma put it, “It would have been unbelievable to have this opportunity when I was a medical student.”

Three-Year MD Program Kicks Off as First Students Take to the Classroom

Posted in Uncategorized on July 30th, 2013 by mars02 – Be the first to comment

This article was originally posted on NYULMC², the internal news site for the NYU Langone community.

Day two for the School of Medicine’s newest group of students—NYULMC’s first-ever three-year MD candidates—found them sitting around a table in Greenberg Hall poring over reading material. A diverse group of 16 students—some fresh out of undergraduate programs, and others with PhDs—had been broken into four smaller groups to discuss articles by Atul Gawande and Malcolm Gladwell published in The New Yorker, highlighting some of the current issues surrounding healthcare in our country.

The orientation meeting and introductory seminar, on their second official day as students at NYU School of Medicine, was intended to spark discussion on the professional ethics of medicine as it’s currently practiced in the U.S. “In medical school, you’re going to focus on the patient across from you, and that doctor-patient bond that is so central to what we do,” said Martin Pusic, MD, who was leading the session. “At the same time, we have to think at the system-level, about the last 100 patients you saw—how can we use Mrs. Jones as an example to think about larger issues?”

In a prime example of the C21 Curriculum at work, students were getting a jump start on seeing the big picture in their chosen profession. They were also diving in head first to the Medical Center’s innovative three-year MD program, the first of its kind in the country that allows students to pursue the specialty of their choice. (While other three-year programs exist, students at those institutions must go into primary care.) Katherine Henry, MD, will serve as the group’s master scholar advisor.

The new program officially began on July 1 with a summer elective class that includes basic cardiac life support training; hands-on work at the New York Simulation Center (NYSIM); a physician reading program, including books such as Polio: An American Story and The Immortal Life of Henrietta Lacks; and a discussion seminar on one of three topics. For this last component, students have a choice of Healthcare Systems Innovation and Policy, led by Mark Schwartz, MD; Global Health, led by Nate Bertelsen, MD, and Michelle Dalla-Piazza, MD; or Gender and Health, led by Ann Garment, MD, and Fritz Francois, MD. “Physicians have a tremendous role in shaping policy and systems, and for the most part, we’re not well prepared to do that,” Dr. Schwartz said of a gap his seminar will begin to address.

The articles sparked some astute observations. The growing evidence that a number of diagnostic tests, when examined across a large group of patients, do more harm than good, was weighed against many patients’ desires to take every conceivable precaution when it comes to their health. One student observed, “For every person you save, there may be many more people who are harmed. But we as a population don’t really want to hear that.”

At an informal lunch afterwards, students and faculty alike went around the room and introduced themselves. In addition to several PhDs, the three-year candidates include a veteran of the volunteer program Americorps, and a former New York City Teaching Fellow. Yet they all have one key thing in common that has brought them together in this unique program: From neurology to radiation oncology to public health, they know exactly what they want to be doing in roughly three years, when they begin their residencies. “I think one of the commonalities with all of us, even those who are right out of undergrad, is that we’ve all had quite extensive experience in our fields,” says three-year student Sarah Pivo. “They’re taking people who have taken time, be it during undergrad or post-graduate, to really explore that interest.”

Sarah graduated from Columbia with an engineering degree in 2008, and then did a masters in economics at NYU. When she found her resulting career path unfulfilling, she took three years to do a post-bac at NYU and work in the pediatric emergency department, doing clinical research. “I had a wonderful chance to work with a lot of patients,” she said. “It really gave me a feel of what it was like to be a clinician. Coming from finance and economics, which was so different, I was so much happier than I’d ever been professionally. It’s given me a lot of confidence that this is the right path.” She plans to specialize in pediatrics.

Jenna Tarasoff studied finance as an undergraduate and worked in investment banking before pursuing a post-bac in psychology at Columbia. “I found I was really passionate about the neurobiology of the mind,” she said. “That’s when I started to get involved in neuroscience research and began considering neurology.” She then did a pre-med post-bac at Columbia and ultimately found her way to the three-year program at NYULMC. “This has been a long path for me, and I’ve known for a while now that I want to do neurology, so this program is obviously very appealing in that sense. I’m ready. Let’s go,” she said.

While Brooklyn native Brian Sanders has just graduated from Yeshiva University, he is no less confident in his choice of otolaryngology, largely because he has also put in significant hours in internships and as a volunteer. In just one example, he spent a year working at Bellevue assisting with clinical research once a week as part of the Pavers Program, which stands for Patient Advocacy Volunteer in Emergency Research Services. He also did research on retinal ischemia in rats at SUNY Downstate. “Part of that was doing procedural work,” he said. “I love working with my hands. At the same time I know that I want to have a well-rounded clinical practice, providing longitudinal patient care as well as procedural work. Otolaryngology will give me all those opportunities.”

For Brian, part of the appeal of the three-year program was its streamlining of the application process, including MD and residency training in one fell swoop. He said, “As someone who knew from high school that I wanted to become a physician, there are so many different levels and stages. You go to high school, you have to pass the SATs, you go to college, you have to pass biology, chemistry, organic chemistry, physics, take the MCAT. It’s kind of nice that NYU says, we think you’re good enough, at this point. We’re going to take a chance on you and accept you, preliminarily, to the residency program.”

Of course, the three-year students have to maintain high academic standards, including remaining in the top 50 percent of their class and passing their step-one board exams on their first try. But knowing they won’t have to go through the residency application process still feels freeing, according to the students. “It takes a lot of uncertainty out of the process,” Sarah said. “Now you can just know, I’m here. I’m going to put my all into this.”

The three-year schedule is made possible in part because of time saved in eliminating the labor intensive residency applications, as well as class time added during the summer. The three-year pathway includes 135 weeks of training, as opposed to approximately 146 for the four-year pathway. Among the other differences, three-year students take their step-one boards at the beginning of their second semester in year two—after they’ve completed their classroom work—instead of waiting until year three, when they’re already into their clinical clerkships. “Ultimately, the number of hours we’re spending in class and clinic is not that different,” said Sarah.

All in all, the students feel there is no real downside to the three-year approach. On the chance that they do change their minds about their area of specialization, they can move into the four-year program. It also comes with a significant cost savings—around $70,000. And while all the students are thrilled to be at NYU School of Medicine, the three-year program was a deciding factor in where to pursue their medical studies. “It’s an amazing medical school,” Jenna said, “but the three-year program is unique.”

Among the program’s other benefits, students all expressed excitement at being made to feel part of their specialty department from the get-go, including access to the mentors who will become their residency advisors. “They’re treating us as a cross between first-year medical students and interns,” Sarah said. They are also actively soliciting feedback from the students. “Every lecture we’ve had, every person who has spoken to us, says let us know what you think, this is the first time we’re doing this. It’s special to have that experience of helping to form the program,” said Sarah. Echoing this, Dr. Pusic told them at one point, “This is your program, and you’re molding it for those who come. You’re involved in shaping the system.”

All the faculty, as well as current medical students, have also given the new students a warm welcome. Brian mentioned the Student Council and School of Medicine Big Siblings programs, and recounted an ultimate Frisbee game in Central Park with mixed teams of new students and current ones (it was a close game, 9–8).

While everyone is excited about the new program and enjoying this honeymoon phase of their medical school careers, there is undoubtedly much hard work ahead as well. “I want to know, is July 4th a holiday?” said one student, when asked if there were any questions, drawing laughter from classmates. A faculty member answered with a smile, “Not for you.”

What is Chagas Disease?

Posted in Uncategorized on May 28th, 2013 by mars02 – Be the first to comment

By Emi Okamoto

Greetings from Santa Cruz, Bolivia! I am taking an extra year to research Chagas disease before my final year of medical school, and am generously sponsored by a grant from the NYU International Health Program.

As Dr. Clarkson first explained in his Southern accent during our parasitology lecture, Chagas disease results from infection with Trypanasoma cruzi. It often causes cardiomyopathy, megacolon, and megaesophagus.  Keep that in mind for your boards studying, because there will be a few lines.  They’ll likely prompt you with a Hispanic patient, as the disease is generally transmitted in Central/South America where its host, the “kissing bug”(! or the boring scientific name: reduviid), survives.

In Bolivia, Chagas disease has already taken about a dozen of our study participants’ lives, and we’ve only been here for 6 months.  Those most at risk usually live in poorer, rural housing, as the kissing bug takes residence in mud and palm constructions.  One patient laughed when I asked if he ever saw a kissing bug.

“Oh doctorita there were thousands,” he said.  “When I was little I used to kill them with a pin- maybe 50 a night.”

Thankfully, a great deal of campaigning for better housing and fumigation have really curbed the infection rates, but there is still a great deal to be done.

Outside Bolivia, chronic Chagas disease is spreading through its immigrants.  An estimated 300,000 people in the United States have Chagas, and about 30% will progress to heart failure or arrhythmias.  In Los Angeles, an astounding 1 in 5 heart failure cases are Chagas in origin.  A recent New York Times article highlighted a Lancet article’s shocking finding: the global economic burden of Chagas outweighs that of cervical cancer or cholera!

So when you study Chagas, do it for the 8 million infected people living in the world.  Or one of the at-risk babies that will be born with the chance of congenital transmission in the U.S.,where the disease will likely go undetected.  Or one of the immigrants presenting to clinic with a family history of heart disease.  Because even though we didn’t know it at the time, those few lecture slides and USMLE First Aid lines are actually quite important.

APAMSA Northeast Regional Conference

Posted in Student Life on April 22nd, 2013 by mars02 – Be the first to comment

By: Yuying Luo

Academic conferences are one of the first opportunities we get that we feel part of a larger community of health professionals. It’s always an exciting opportunity to listen to talks given by experts in the field and meet fellow medical students (who will one day be our colleagues!). One of the perks of attending NYU is that every student organization can send four students to a relevant academic conference during the year.

NYU’s APAMSA (Asian-Pacific American Student Association) executive board was fortunate to attend APAMSA’s Northeast Regional Conference held on March 9, 2013 at the Icahn School of Medicine at Mount Sinai. The theme this year was “A Changing Landscape” and featured a lineup of speakers who brought diverse perspectives on the health issues facing Asian Pacific Americans. There were a range of topics covered, from promoting mental health for Asian Americans, language barriers as a risk factor for minorities seeking care in the Emergency Department, and an engaging talk by Dr. Andrew Kaufman (a NYU med alum) on minimally invasive and lung sparing surgery for early lung cancer.

It was an educational and inspirational experience for us all. Definitely take advantage of the opportunities early on in your medical school journey to remind yourself why you decided to choose a career in medicine in the first place.

Decisions, Decisions: Revisit Helps the Right Incoming Students Find a Home at NYULMC

Posted in Uncategorized on April 19th, 2013 by mars02 – Be the first to comment

This article was originally posted on NYULMC², the internal news site for the NYU Langone community

Prospective members of the class of 2017 got a firsthand look at the NYSIM center as part of Revisit.

Not all medical schools are created equal. Last Thursday and Friday, April 11 and 12, representatives from the School of Medicine here at NYULMC had a chance to show off what sets it apart from the rest, at the SoM’s annual Revisit event for prospective students.

About 100 potential members of next year’s incoming class—which will ultimately include around 160 students—enjoyed dinner at the Kimmel Center at Washington Square, talks from faculty about the innovative approach to medical education at NYULMC, hands-on training experiences at the NYSIM center, and perhaps most importantly, a chance to mingle with current students and hear about their experiences, including what they value most about being at NYULMC.

“In my opinion, what makes NYULMC stand out from other medical schools is our unparalleled clinical training, vibrant student body, and amazing location in NYC,” said Cristen Cusumano, a first-year student from Wyckoff, New Jersey, who was in charge of rallying classmates to this year’s event. “Having a diverse group of current students from all years able to make time in their busy schedules to speak with prospective students was critical to the success of Revisit, as we were able to show the potential incoming class what makes NYULMC unique and why we all love being medical students here,” she explained.

A hands-on look at medical education at NYULMC, at NYSIM.

Cusumano is one of NYULMC School of Medicine’s student ambassadors, a student-run leadership initiative charged with acting as representatives and fostering communications between current, future, and former classmates. In addition to helping with Revisit, they work with the Admissions Office throughout the year, hosting, giving tours and even interviewing prospective students. About 40 ambassadors attended this year’s Revisit event, sharing their experiences at NYULMC over lunch panels, the Kimmel Center dinner, and other events.

On Friday morning, prospective students heard presentations from leaders at the School. After being welcomed by Rafael Rivera, MD, associate dean for admissions and financial aid, Victoria Harnik, PhD, assistant dean for curriculum, spoke about C21, emphasizing its options for customization; Fritz Francois, MD, associate dean for academic and diversity affairs, presented on BMI in Medicine; Marc Triola, MD, associate dean for educational informatics, and John Qualter, professor of educational informatics, talked about the expanding role of technology in the curriculum; and Lynn Buckvar-Keltz, MD, associate dean of student affairs, and Joe Oppedisano, director of student affairs, presented on “The Integrated Medical Student.”

Prospective students had ample time to mingle with current ones.

After the speakers, it was time to head over to the NYSIM Center, where prospective students participated in four training modules. It was a chance to experience the state-of-the-art center, just one piece of the forward-thinking technology that drives the C21 curriculum. But while C21 and features like NYSIM are major selling points, in the end Revisit is about finding the right match on both sides.

“At its core, it’s about people and fit,” says Dr. Rivera. “We want to make sure we’re a good fit for our applicants and vice-versa, so Revisit provides an opportunity for applicants to get to know our students, our faculty, and their potential future classmates over two days filled with didactic, interactive and social sessions. The hopeful end result? That it contributes to our ability to recruit the very best and brightest students for NYULMC.”

A reception at the Kimmel Center kicked things off on Thursday, April 11th.

 

The Art of Medicine: Art & Anatomy Class Helps Students and Staff See the Person as Well as the Patient

Posted in Uncategorized on April 10th, 2013 by mars02 – Be the first to comment

This article was originally posted on NYULMC², the internal news site for the NYU Langone community

First-year medical student Annie Wang at NYULMC’s Art & Anatomy class, part of the Master Scholars Program in Humanistic Medicine.

 

“Drawing is such a great way to learn anatomy for students. You commune with the thing you’re drawing. You take it in in a different way than you do when you’re dissecting it. You develop this personal connection with it,” says Laura Ferguson, now in her fifth year as artist-in-residence at NYULMC. For the 10 semesters she’s been here, she has taught the drawing course Art & Anatomy, one of the ongoing offerings of the Master Scholars Program in Humanistic Medicine, under the auspices of the Office of Student Affairs.

In the words of program director, associate professor Allen Keller, MD, the goal of Art & Anatomy and the other seminars offered by the program each semester, is to “encourage students to explore other areas they’re not necessarily getting elsewhere in the curriculum, to help them maintain, nurture, and even grow their idealism.” He adds, “Most individuals come to medical school idealistic. At too many medical schools, that gets beaten out of them. At NYULMC, we really are committed to maintaining that.”

Most of the program’s seminars—which this semester also include The Art of Seeing, which features trips to the Metropolitan Museum of Art, and Literature and Addiction, as well as a popular healthy cooking course which, like Art & Anatomy, is offered every semester—are open to all members of the Medical Center community. (The cooking class, open only to medical students, is the one exception.) “It’s a wonderful opportunity where you have students, residents, faculty, and other individuals from a variety of areas who work at the Medical Center,” says Dr. Keller. “Otherwise, we would not likely be sitting in the same room together.”

 

At a recent session of Art & Anatomy, first-year medical students huddled together, many of them chatting away as they drew bones and organs with charcoal or pencils. Another table of artists went about their work more quietly. “It’s just a chance to relax a little bit—wind down the day,” says Abe DeAnda, MD, attending physician in cardiac surgery, who is taking the class for the second semester in a row (it gets many repeat takers). He adds that he is not new to the practice of drawing. “But this is a nice environment to do it in. It’s just a good excuse to get away for an hour and a half a week.”

Andrea Tufano (pictured right, foreground), a faculty group practice assistant in cardiology, also finds that the class is a great way to relax after work, as well as an unusual chance to get up close to the human body. “Where else do you have the opportunity to go into the anatomy lab, and not be stressed about learning all this? Here, we just get to enjoy it and see the beauty in it,” she says.

For Natasha Bobrowski-Khoury, the class makes an excellent complement to her work as a technician in the Department of Physiology and Neuroscience. “As part of my job, I do dissection. It’s not exactly the same,” she explains, since her lab works with mice. “But it’s close enough, because I am working with something that translates to humans. And I’m planning to go to med school, too, so this is kind of introducing me to anatomy already.”

For the medical students, almost all of them in their first year, the class is a welcome break from the rigors of their main curriculum. Annie Wang, who was a pre-med student before coming to NYULMC, finds it provides much-needed balance. “In undergrad I just didn’t have time for anything else, and I really wanted to have something other than school in my life. . . . I did a lot of art in high school, and then I kind of just forgot about it. Now I have the chance to come back to it and it’s really fun.” She adds that it also helps her reflect on the human body in a different way, knowing that she is drawing an actual person. “It’s a little bit of a different perspective on what art is, and it makes you think about bigger questions.”

Her observation is a perfect example of the Medical Humanities Program’s goals at work. Katie Grogan, PhD, the program’s administrator says, “Art & Anatomy is a great example, where students are spending so much time in the anatomy lab anyway, but are actually signing up to come back and spend even more time, because the work they’re doing in a seminar like this is so different, and they sort of reflect on that whole experience. The concept of death and dying—it offers this other platform for them to process that.”

Laura Ferguson concurred that the class provides a connection between seeing the human body, and seeing the person. “The great thing about the Art & Anatomy class, you really see how each body is different. When you’re drawing, if you draw a heart, you’re drawing that particular heart. You want it to look like a portrait of that heart, as opposed to a drawing in a medical textbook, where it’s the most generic heart.”

She continued, “What we try to do is focus on individuality. So you’re thinking about the person whose body it was. Even a bone got to be the way it is partly because of the way that person lived their life: how much walking they did, how strong they were, how much muscular effort went in to shape the bone and make it different from someone else’s bone. I wanted them to have that kind of take on the body, because in med school they dissect and they memorize and they learn all the different parts, but they may not have that connection to the real person—especially the non-diseased person, or the non-pathological person.”

The class, which is offered every semester and is open to all Medical Center faculty and  staff, is held in the anatomy lab in the MSB basement.

 

The Masters Scholars Program, pioneered in 2000 by Steven Abramson, MD, now chair of the Department of Medicine, and Mariano Rey, MD, then dean of students, evolved into its current iteration in 2008 and is now a model for other programs around the country. “There has been so much research about the benefits of the humanities in medical education and rates of burnout in medical school, and how valuable work in these disciplines, and self-reflection is in combating that,” says Dr. Grogan. “We’ve had medical students say that when they were choosing a school, they looked to see what the offerings were in medical humanities.”

The classes also provide a way for diverse members of the Medical Center community to come together around the values—compassion, empathy, communication, justice—that the program advances. “It takes advantage of our broader community and helps us connect,” Dr. Keller said. “It teaches all of those who participate in these activities how interdisciplinary and interdependent ideally medicine and health are. Bringing art, bringing science, bringing humanistic values, are all really important.”

As Dr. Grogan put it, “It’s not tangential to medicine. It’s really intrinsic.”

 

 

Helping Underserved Populations through the Hepatitis Project

Posted in Uncategorized on March 25th, 2013 by mars02 – Be the first to comment

By Leigh Nesheiwat

One of the many things that I love about NYU School of Medicine is the opportunity to immerse myself in student life. Within days of starting medical school, I was receiving e-mails about dozens of club events that were being organized by second-year medical students. I’ve always had an interest in infectious disease and decided to join the Hepatitis Project, an organization designed to provide vaccinations to underserved populations throughout Manhattan. Through this organization, I became involved in the Streetworks Project, a service that caters to homeless and runaway youth aged 11-24. As an undergraduate student, I was a member of an outreach program that helped socioeconomically disadvantaged children overcome the various hurdles that they are forced to confront. Streetworks allowed me to not only gain clinical exposure, but also continue my passion for helping underserved youth.

Throughout the semester, I went down to the Streetworks site and administered Hepatitis A and B vaccines. As a first year medical student who had just started medical school, I couldn’t believe that I was actually giving vaccines to people and helping make a difference in the lives of others. When leadership transitions came around for new club leaders, I knew that I wanted to become more involved in the Hepatitis Project and help this unbelievable organization grow into something even more profound.

As two of the Co-Presidents for the Hepatitis Project, Mike, a fellow first-year medical student, and I are working with the Lower East Side Harm Reduction Center (LESHRC). Similar to Streetworks, the LESHRC caters to underserved populations. However, this organization targets adults who are homeless and/or IV drug users, a population that is particularly susceptible to various infectious diseases that we are vaccinating against. At LESHRC, we provide free Hepatitis A, Hepatitis B, and Influenza vaccines to our patients. We will be expanding the Hepatitis Project this semester by incorporating rapid HIV testing and counseling into our program and are both very excited about the future of this organization.