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  • AMSA National Leaders Publish Survey in BMC Education

    Advocacy is increasingly being recognized as a core element of medical professionalism and efforts are underway to incorporate advocacy training into graduate and undergraduate medical school curricula. While limited data exist to quantify physician attitudes toward advocacy, even less has been done to assess the knowledge, skills and attitudes of future physicians

    Congratulations to AMSA national leaders - Kristin Huntoon, Colin McCluney, Dr. Elizabeth Wiley (AMSA National President), Christopher Scannell, Richard Bruno and Dr. Matthew Stull (Graduate Trustee) - who recently published, "Self-reported evaluation of competencies and attitudes by physicians-in-training before and after a single day legislative advocacy experience," in BMC Education. Here is the link: http://www.biomedcentral.com/1472-6920/12/47/abstract. The purpose of this study was to assess students' experiences and attitudes toward legislative advocacy using a convenience sample of premedical and medical students attending a National Advocacy Day in Washington, D.C. in March 2011.

    Data from 108 pre-advocacy and 50 post-advocacy surveys were analyzed yielding a response rate of 46.3%. Following a single advocacy experience, subjects felt they were more likely to contact their legislators about healthcare issues (p=0.03), to meet in person with their legislators (p<0.01), and to advocate for populations' health needs (p=0.04). Participants endorsed an increased perception of the role of a physician advocate extending beyond individual patients (p= 0.03). Participants disagreed with the statement that their formal curricula adequately covered legislative healthcare advocacy. Additionally, respondents indicated that they plan to engage in legislative advocacy activities in the future (p<0.01).

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  • New @ 2011 AMSA National Convention: Thought Leaders Series

    Katherine Ellington
    Vice President-Elect, Program Development
    National Chair,Wellness & Student Life Committee
    St. George's University School of Medicine

    A few months ago, I had a conversation with Dr. Matthew Stull, AMSA National Education & Research Fellow about new programming during convention. He discussed the vision for a new “New Thought Leaders” series of talks to provide more opportunity to hear from a broader range of leading voices within the profession of medicine.

    The new “Thought Leaders” series included 3 sessions held on Friday morning. The first featured Dr. James Prescott, chief academic officer at the Association of American Medical Colleges (AAMC), which carries a mission to serve and lead the academic medical to improve health care for all. Dr. Prescott is enabling the AAMC dialogue to help the profession of medicine rethink approaches to the medical education continuum. He acknowledges a new era of transformation in medical education as well as the complexity of our changing health system, which also affords new opportunities (e.g. new medical schools). The commitment to embrace quality and excellence stands unchanged, consider the core competencies for every physician:

    Patient care that is compassionate, appropriate,and effective
    Medical knowledge
    Practice-based learning and improvement
    Interpersonal and communication skills
    Professionalism
    Systems-based practice

    Dr. David Nash, the new Founding Dean of the Jefferson School of Population Health, Thomas Jefferson University provided a conversation from his decades of experience in quality-of-care improvement and outcomes management. He also discussed his new book, Demand Better: Fix Our Broken Healthcare System (2011). Dr. Nash’s blog offers rich discussion on health policy. 


    Gloria A. Wilder, M.D., M.P.H. Inductee, Gold Humanism In Medicine Honor Society & Founder, Core Health LLC practices“street doc” medicine and mobile patient care. She offered discussion on five components driving health:

    1- Access to quality healthcare

    2- Access to quality education

    3- Fair economic opportunity

    4- Environmental justice

    5- Access to an unbiased legal system

    Dr. Wilder is well-known for her real talk, pushing us to think about the interplay between our environment and health. For example, a situation where a child continues to return to the doctor with episodes respiratory distress needs more care than a new prescription for albuterol, it's time for a home visit, if the child lives in poor housing conditions (e.g. mold, poor ventilation) changes need to be addressed before any medicine can be effective.

    special thanks for notes on Dr. Wilder’s talk from Kimberly Fe'Lix Kimes,
    University of North Carolina at Charlotte
    Premedical Regional Director- Region V
    Premedical Trustee-Elect

    The Thought Leaders series was sponsored in part by The New England Journal of Medicine

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  • A Practice of Compassion: part 2

    Aliye Runyan
    Incoming AMSA Medical Education Action Committee Chair
    University of Miami-Miller School of Medicine

    The theme of compassion was elaborated on by two other presenters during AMSA's Annual Convention & Exposition – Jack Coulehan’s session “The Patient is Why I’m Here: Humility and Professionalism in Medical Training” and Allan Peterkin’s “Creative Writing for Teaching and Evaluating Professionalism”.

    Coulehan, professor emeritus and senior fellow of the Center for Medical Humanities at Stonybrook University in New York, spoke to a definition of professionalism, which indeed includes compassion. He quoted John Gregory, eighteenth-century Scottish physician and writer: “The chief quality [in practice of medicine] is humanity, the sensibility of heart that makes us feel for the distress of our fellow creatures, and which, in consequence incites us…to relieve them.”

    “Humility is the most absent of virtues in medicine”, Coulehan observed. He went on to discuss humility as self awareness, unpretentious openness, and gratitude for the privilege of caring for others. Techniques for conveying such attributes in medical education were discussed – such as Balint groups and interprofessional leadership training among the various health care professions.

    Allan Peterkin, author of “Staying Human During Residency Training”, and associate professor of psychiatry and family medicine at the University of Toronto, helped to wrap up the convention weekend with his Sunday morning storytelling session. Peterkin led students through the CanMEDS prompts for teaching professionalism in Canadian medical schools, and created a 20 minute quiet space in which attendees could write to each prompt. Students were then able to share their stories, and to give and receive feedback on each’s strengths, edits, and possibilities. This model and others like it provide an outlet for the daily frustrations and joys encountered in the medical practice, and serve to develop a physician or physician in training’s self awareness as well as their perspectives on patient care, the medical system, and their role within it.

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  • Communication and Collaborative Technologies

    Scott Hagan
    Vanderbilt School of Medicine, Class of 2013

    Dr. Danny Sands, President of the Society for Participatory Medicine and Director of Medical Informatics at Cisco Internet Business Solutions, gave a great presentation (slideshow available here) on the use of emerging technologies to improve patient-physician communication in healthcare on Saturday, March 12th at the AMSA Annual Convention & Exposition. Some particular points that I found intriguing:

    • Pagers are quickly becoming irrelevant in medicine, as physicians are moving toward smartphones and cell phones to receive messages. This is a welcome change, as beepers are an inefficient way of communicating.
    • In general, inefficient communication in the hospital accounts for a massive amount of wasted time. For example, 65% of nurses spend than 20-60min/shift just trying to reach staff, and over 66% use more than one channel of communication to do so.
    • According to the Joint Commission, communications failures are considered to be the greatest contributor to sentinel events in hospitals. Thus it is a moral imperative for the future clinician workforce to improve the processes of communication in healthcare if we are to do right by our patients.
    • New forms of e-Communication, whether it be improved patient access to their health information (like Beth Israel’s http://www.patientsite.org) or advanced telemedicine that allows clinicians to interview and even to record signs of patients remotely, are revolutionizing the patient experience, and we should welcome new technologies that empower patients and increase the efficiency and ease of communication.
    • Both provider and patient use of social media has exploded in the past 5 years, whether it be Twitter (check out Sands’ recommendation of 140 Health Care Uses for Twitter), Facebook, I Move You, or the myriad blogs and websites on health care.

    To read more about Dr. Sands, follow him on Twitter. Also check out the blog of his most famous patient, e-Patient Dave, who blogs about patient empowerment.

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  • A Practice of Compassion

    Aliye Runyan
    Incoming AMSA Medical Education Action Committee Chair
    University of Miami-Miller School of Medicine
    Keynote speakers Dr. Patch Adams and Susan Parenti, from the Gesundheit Institute (www.patchadams.org), provided a meaningful and compelling welcome to AMSA’s 2011 Annual Convention & Exposition. 



    Parenti (pictured) emphasized the importance of “nesting” – nurturing that which is vulnerable- in this case, the process of healing and care of patients – in a nurturing community. This is the background for Adams’ brainchild – the design and now, building of a completely not-for-profit health care organization that is a project in holistic medical care – based in West Virginia. The project is a response to what Parenti and Adams call a “cry for compassion” from patients. The pair stress that burnout among physicians can be attributed not to too much time spent seeing patients, but too little time per patient, leaving both provider and patient unfulfilled. They emphasized the importance of the “bidirectionality” of the physician-patient relationship over time, and that the health of the staff in medicine is just as important as health of patients.

    Adams stated that medicine is “a practice of compassion” and “no medical school in the world teaches compassion”. He proposed a “study of compassion”, in which a cell of four students collect information about observations on the giving and receiving of compassion for a two year period – the first six months being a time for the breakdown of preconceived judgments. Learn to be comfortable with the language of compassion, Adams implored. Notice how you and those around you give and receive love. Learn the types of people you tend to avoid and befriend such a person.

    In response to a question about the use of self-reflection as a tool for teaching compassion and self-care in medicine, Parenti responded that we should reflect, but to go a step beyond and ask “what is my vision to make a situation better or different?”

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  • Patient is Why I’m Here

    Lorenzo R. Sewanan
    Trinity College, Class of 2012 
    When I start medical school, I fear that I will lose my balance between myself and my work in the pages of my anatomy book, I fear that I will forget the humanity of my patients in between the cuts of my dissections, and I fear I will listen more to my patients but hear less the pain in their voices, their need for compassion. During a session at AMSA's Annual Convention, Dr Coulehan reveals that these fears are common among medical students and not unfounded. It is exactly these elements especially the training of a doctor to be objective rather than empathic that have been taught in medical schools over the past fifty years especially, the philosophy of detached concern. However, research by prominent medical educators has shown this philosophy engenders self-absorption, rigidity, and even a sense of entitlement among physicians, leading to masochistic culture of arrogance, gamesmanship, and to some sense an inadequacy to heal.

    In other words, exactly opposite of what make physicians really effective with their patients and legitimately capable of wielding the responsibilities of being a healer. Above all, physicians needs to have intellectual virtues like excellence, practical wisdom, and life-long learning, and moral virtues like integrity, fidelity, compassion, courage, humility, and justice. And, everyone knows this. Everyone knows the qualities it takes to make a good physician, in someone’s immortal words “firmness of mind” and “gentle and humane temper”. Yet, there is a great gap between what medical professionals know and what they are observed to do when it comes to these softer skills, a disparity which is eroding the very foundations of medicine.

    So, what can we do to maintain compassion? How do we unite tenderness with steadiness? How do we help medical students develop a personal moral balance? For Dr Coulehan, there’s one way that works for medical students: taking time out formally in a small group format to think, to discuss, and to write about the medical school and residency experience.

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  • Medical School Dean Panel: AMSA Convention

    Lorenzo R. Sewanan
    Trinity College, Class of 2012

    The medical schools admissions deans didn’t seem to me at all that terrifying. But someday, these four people, two from MD schools and two from DO schools, might hold my fragile dreams in their hands, weighing all they know of me to make a decision. The decision for admission. However, they were eager to share with us some vital tips, some common and some less common and more sincere, on what the premedical students should strive to be and on what medical schools look for in applicants.

    Each and every dean emphasized that the key assessment revolves around how prepared the applicant appears for the challenges of medical school and a medical career, academically, psychologically, and emotionally. The applicant must present himself/herself on paper and in person such that patients could feel comfortable seeing you down the road. In addition to intelligence, the applicant must display good listening skills, empathy, compassion, and the variety of softer interpersonal skills necessary to interact well with other human beings. Of course, the applicant must not fake it; he/she should be himself/herself (within reason).

    The deans also stressed the importance of using the personal statement to not only reiterate one’s reasons for wanting to go into medicine but also one’s achievements and especially medical experience, including shadowing and volunteering. No one should go into medicine without first testing it though first hand significant clinical experience. As one dean put it, the premedical student should have been able to smell the patient in his work or volunteering.

    During interviews and visits, everything is taken into account. Applicants should demonstrate honestly that they are excited to be there and that they are willing to engage with anyone and everyone. The applicant should also know thoroughly the school philosophy, curriculum, and opportunities. Take advantage of online resources and student ambassadors to find out more about schools. And, when it comes to questions, applicants should be honest, be humble, and spin the question to their advantage.

    The ultimate admissions decision rests on two questions. “Are you someone I want as my partner and peer in medicine?” “Are you someone I want taking care of me somewhat down the line?” All of the deans emphasized that medical school changes your life, and if it’s meant to be, don’t ever give up hope.

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  • My favorite session at AMSA's Convention....A Premed's View

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  • Ideologies dictate Expert Debate on Health Care Reform

    Carl G. Streed Jr.
    Johns Hopkins University School of Medicine, Class of 2013

    After a jolt of caffeine, I was ready to engage in the health care reform debate in AMSA’s “On the Hot Seat: Health Policy Experts Debate.” However, what I found there was more hand waving and ideological entrenchment than actual reform.

    The debate opened with Michael Cannon from the CATO Institute arguing that the PPACA needs to be completely repealed, Medicare saves no one, and that doctors should not advocate on behalf of their patients. I work really, really hard to remain opened minded, but when I am offered no data, no statistics, and no references to turn to so that I may comb through the facts, I’m highly skeptical. Additionally, repealing PPACA without offering solid solutions just doesn’t sit with me. 

    Following Cannon, Robert Zarr M.D. of the Physicians for a National Health Program, inundated the audience with graphs and data that suggested the needed for a single-payer model following the collapse of the current healthcare system in the United States. Advocating for change following the utter ruin of the current system and the subsequent harm to our patients did not sit well with many in the audience; waiting for the house to burn down before going in to offer a solution doesn’t make for sound reform (might have worked for Chicago in 1871, not so much for health care now. 

    In the end, the debate was more slings and arrows across ideologies than an exchange of ideas.

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  • My favorite session at AMSA's Convention....

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