17th Health and Human Rights Conference held

By Aalok Shah (Meds 2020), HHRC Conference Co-Chair

Human Rights, a concept that has existed for millennia and documented in seminal political and religious documents such as the Magna Carta and the Vedas, got a more modern treatment in November 2017 at the Health & Human Rights Conference (HHRC). The HHRC is a proud tradition of Queen’s medicine students, who have organized this conference autonomously for the past 16 years. Since its inception in 2001, this conference has evolved in both

Advocacy through art: Wall of Courage

scope and reach, reflecting the push for interdisciplinary learning and collaboration in education. The 17th iteration of the conference reached out to professionals both within and outside of medicine to educate and engage delegates on its theme of “affirming the human right to health for the poor.” With generous donations from organizations such as the Ontario Medical Students Association (OMSA) and the Canadian Federation of Medical Students (CFMS), the 17th HHRC was the first student-run conference in Canada to welcome over 150 students from all over the nation to discuss human rights and health.

The conference itself was divided into two days.

Community Initiatives Fair

The first day was more didactic in nature, featuring events aimed at educating delegates on traditional social assistance programs and the newer model of the basic income guarantee. Sheila Regehr, the chair of Basic Income Guarantee Canada, gave a keynote address explaining both the philosophical and practical reasons for incorporating a basic income model of social assistance, and its impact on health of the poorest populations in Canada. After this address, delegates witnessed a debate between economists, politicians, and professors on whether a basic income guarantee should replace traditional social assistance programs in Ontario. While parts of the debate were very technical and required knowledge of economics, many delegates reported learning a lot more about the issue with a better appreciation of the pros and cons of both sides.

Global Health workshop

The second day was more interactive, offering several workshops that engaged delegates in topics including indigenous health, global health, mental health, and art-based interventions in health promotion. Additionally, the “community initiatives fair” provided a great opportunity for delegates to interact and network with organizations in Kingston that are involved in local development work. Some students signed up to volunteer at such organizations during this time, and appreciated the chance to channel their motivation and energy from the conference into action right away. Finally, the second day also featured Dr. Samantha Green, who gave a keynote address on mental health, and offered practical tips for healthcare providers in engaging with patients who may be facing financial or emotional calamities.

Overall, the conference was successful in renewing a discussion about intrinsic rights of humans to health, and how to best achieve equity in an era of equality. This conference would not have been possible without the hard work of the executive committee of 13 people featured below and generous sponsors including the Aesculapian Society, the Dean’s Fund, OMSA, CFMS, Queen’s Innovation Centre, Principal’s Office, Society of Graduate Studies, School of Kinesiology, Global Development Studies, Queen’s Human Rights Office, and the Office of the Vice-Provost.

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New and improved resources for teaching, research and clinical application

By Suzanne Maranda, Head Health Sciences Librarian, Queen’s University Library

(Italics indicates a hyperlink)

Are you looking for images to include in your presentations or online modules? Two Thieme products are now available online and any materials from these two resources, one in Anatomy and the other in Pharmacology, can be extracted and included in any materials that will be used in a Queen’s course or presentation. Please contact me if you would like the complete license agreement.

Usage statistics of these resources will be collected to inform our decision about renewing or not. There are two other products (Physiology and Biochemistry) from the same publisher that could be added if requested and if funds permit. The two subjects purchased were chosen in consultation with the staff preparing online modules for the BHSC program.

The other tool I would like to highlight is relatively new as it was added in September 2017. Read by QxMD is a mobile app that enables a more direct link to the journal articles subscribed by the Library and to open access journals. The link provided here is to the page of all our mobile apps, please scroll to the instructions on how to get Read to work with the Queen’s resources. When you set up a profile, you can receive email notifications of new articles that match your profile. Check out the new “medical education” option that I requested be added. This company is quite responsive, I would be happy to pass on other topic/category suggestions.

Isabel is a diagnostic support tool that can be useful in clinics and possibly for teaching clinical skills. In December 2017 the librarians participated in a webinar with the developer of Isabel to review software enhancements.

Once a few symptoms are entered, a list of possible conditions is presented for follow-up, the coloured bar on the side (see green arrow) of the list indicates the strength of the likelihood (red is best). Notice the separate tab at the top of the results box for possible drugs ( ) that may cause the symptoms you entered. By clicking on a condition, you are taken to the Dynamed entry by default. If there is no Dynamed entry, then we link to BMJ Best Practice. A few other resources have been added for linking, you see these in the left hand box, so that one can choose to look at a different resource, or even consult more than one. There is a mobile version of this clinical tool, see instructions on our mobile apps guide.

I hope you will try Isabel and consider completing the online survey (at the red arrow) that is linked from the Isabel pages to ask for your feedback about this resource.

As always, do contact us if you have any questions about the above resources or anything else information-related.

 

 

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Queen’s Medicine Pre-Clerkship South East Asia Observership 2017

By Cesia Quintero (MEDS 2020)

In June and July of 2017, a cohort of six first year medical students from Queen’s University conducted a month-long observership in Vietnam and Cambodia. The goals of the trip were to provide the students with a valuable clinical experience and exposure to Global Health, and to establish connections that might expand the availability of Global Health experiences for future Queen’s medical students. We also hoped to explore the possibility of creating unique partnerships with overseas institutions that would boost the global profile of Queen’s University.

We examined a Neurocysticercosis patient at NIMPE

 Overview

The bulk of our two-week Vietnam stay was at St. Paul’s Hospital in Hanoi, Vietnam, where we had a chance to observe in a variety of departments, including ICU, ER, Pediatric Infectious Disease, Pediatric Cardiology, and Endocrinology. Our visit was initially sponsored by the director of the Endocrinology department at St. Paul’s, and throughout our stay we managed to make good connections with several other physicians, including the director of the ICU. All of these physicians expressed interest in a similar arrangement next year. We also had a chance to have a one-day observership at the National Institute of Malariology and Parasitology (NIMPE), where we saw patients with parasitic infections that we would not have an opportunity to see in Canada.

The connections we made in this portion of the trip allowed for the possibility of more in-depth observerships at NIMPE in the future, and for expanding this opportunity to the National Hospital of Tropical Diseases. We also made connections that could allow us to similarly access the health system in the Lao People’s Democratic Republic.

During our Cambodia stay, we spent one week at Battambang Provincial Hospital, which is one of the larger provincial hospitals in the country, and at the Pailin Referral Hospital, a very under-resourced hospital that serves 75,000 rural residents. We quickly learned that Battambang Hospital routinely hosts students from Australia and the UK; during our stay there, there was a group of four medical students from the UK and 22 nursing students from Australia. Both the coordinator for foreign students and the director of the hospital indicated that they would love to form a relationship with a Canadian medical school. In Pailin we became closely acquainted with the Deputy Minister of Health of the province, as well as with the director of the hospital, and several department directors. At both Cambodian hospitals we spent our time in the ER, Pediatrics, Labour and Delivery, and OR.

Clinical Experience

Battambang Surgery Observership

In all of the hospitals, our role was strictly that of observers. The physicians who oversaw us facilitated a learning model in which the goal was for us to begin to recognize common signs and symptoms and gain first-hand experience with positive findings. Our activities consisted of observing patient care, impromptu mini-lectures from supervising physicians to illustrate relevant findings, and non-invasive supervised physical examinations. We were introduced to patients as foreign medical students by our supervising physicians, and in Battambang by our medical translator. We found that it was very helpful to point to our student IDs and highlight the word ‘student’ whenever it seemed that a patient was mistaking us for a doctor.

Throughout the day we did a lot of research on our own to answer any questions that came up. We found that having the ability to observe the same patients multiple times a day, several days in a row, was a huge advantage, as it allowed us to observe the progression of disease and treatment. For example, we had the opportunity to follow a patient with diabetic ketoacidosis from his admission to the ER to the ICU, and his eventual passing away, at each stage observing and researching the changing signs and symptoms, treatment efforts, and reactions from his family. We also found that seeing so many positive findings and performing so many physical examinations on actual patients greatly increased our confidence and clinical skills. Depending on our setting, we had the opportunity to observe a variety of procedures, including intubations, central line placement, wound care and debridement, deliveries and surgeries.

Managing Impact

A former soldier was awaiting a toe amputation in Battambang

In all of this, we strove to be mindful of how busy and overworked the physicians were, and to operate by the principle that no patient experience or outcome should be negatively affected by our presence; if possible, we tried to be a positive presence for the patients. We are proud to say that we honestly believe we were able to live up to this goal. By separating into small groups, rotating departments frequently, and being independent learners for the majority of the time, we were able to avoid being a major burden to hospital staff. We also respected patient privacy as much as we could. Nevertheless in all hospitals there were a number of patients to whom a group of foreign students was an exciting event, and there were many occasions in which we thought our presence had been beneficial to a patient’s experience or outcome. In Battambang, a former soldier and his family burst into tears after some of us gave him a very respectful greeting in Khmer language; they said they had never received so much respect from someone in a white coat, and this was very meaningful to them. In Hanoi, we were able to comfort a very anxious ICU patient by listening to her heart several times a day when the physicians did not have time to attend to her emotional distress. There were multiple emergency situations throughout in which physicians borrowed our stethoscopes and other equipment, such as during a failed intubation.

Pailin’s TB ward houses both patients and their families, who don’t have protective equipment.

It was in the understaffed and under-resourced Pailin Referral Hospital where there was the biggest opportunity for us to be a beneficial presence, and where one of the most impactful experiences of the trip took place. I went to check in on a TB patient who was faring poorly, and found that the physician on duty had not looked in on her for several hours. When I arrived, there were no nurses of other staff in the ward. She was alone, struggling to breathe, and her family was very distressed. I immediately phoned her admitting physician, who arrived minutes later. Nasal cannula were the only available tool to provide oxygen, but luckily we had a rebreather mask with us that could be connected to the oxygen tank. There were no monitors to keep track of her vitals, but we had brought a pulse oxymeter with us. When, despite the oxygen, her pulse and breathing stopped, three of us medical students were the only ones available to assist the doctor in performing CPR. The doctor himself would have been performing CPR without an N-95 mask if we had not been able to provide one to him.  Unfortunately the patient passed away despite these efforts, but we were satisfied that our presence there had afforded her a better chance, and that at least her family witnessed medical staff making their best effort to save their wife and mother, who would have otherwise died alone and without medical help.

Global Health Experience

Empty shelves at Pailin Hospital’s Outpatient Pharmacy, which serves 75,000 people

Due to the low-resource setting of these observerships, a lot of our learning went beyond the clinical. Both Cambodia and Vietnam are undergoing rapid economic development and demographic changes; the consequent epidemiological transition was highlighted time and again by physicians. We also witnessed the impact of patient crowding and severely exacerbated conditions due to lack of access. Particularly poignant were the struggles of physicians to provide medical care under extremely exacting conditions, such as limited resources and training, and political difficulties. We gained a better understanding of the multifaceted nature of these challenges, and of how difficult it is to bridge these gaps effectively. We also saw, however, that it is possible to make a difference. For example, we brought medical equipment with us that is currently filling some gaps at the Pailin Referral Hospital.

 Future Possibilities

With the director of Pailin Hospital. Fundraising efforts throughout the school year allowed the students to donate medication and equipment

While all institutions that we visited expressed an interest in hosting Queen’s medical students in the future, near the end of our trip the director and several physicians at the Pailin Referral Hospital requested a meeting with us. They wished to explore the possibility of a closer relationship with our university. There were a variety of areas for collaboration that were proposed at this meeting, including the possibility of hosting clerks and residents who, unlike us, might be able to provide medical assistance to patients while being exposed to new situations and gaining useful skills. The director and staff indicated that the most critical needs for the hospital are 1) diagnostic equipment, and 2) advanced training for staff. The only imaging available at the hospital is a rather outdated x-ray machine that generates fuzzy images. In terms of training, their most emergent need related to the management of diabetes. Due to the epidemiological shift, widespread diabetes is a fairly recent phenomenon in rural Cambodia. Nevertheless, Pailin Hospital physicians estimated that currently up to up to 60% of their patients have diabetes. They are very motivated to improve their knowledge of and experience with managing this disease at such high frequencies, and asked about possible training methods they might be able to access, such as online modules or intensive training by diabetes specialists.

In response, we took notes of their concerns and promised to pass them on to the appropriate stakeholders at Queen’s Medical School. We also began independent efforts to find a digital x-ray machine for donation, and continue to look for ways to support the development of this hospital.

Conclusion

The trip exceeded our expectations in terms of the quality of clinical experience and global health exposure that was achieved, the receptiveness of our hosts to continuing this project, and the possibility for future in-depth, mutually beneficial collaborations at the institution level.


 All photographs were taken for fundraising and educational purposes only, after obtaining informed consent from all parties.

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From campus to community: the Loving Spoonful Service Learning Project

By Steven Bae and Lauren Wilson, MEDS 2019

“Let food be thy medicine, and medicine be thy food” – Hippocrates

Food. It is a vital part of our existence, and is a focal point in many cultures. Over the course of one year, a person who eats three meals a day consumes 1092 meals. It plays such a large role in everyday life that sometimes it is easy for us to overlook.

The importance of food security to one’s overall health is well known. Food security is defined as “all people, at all times, have physical and economic access to sufficient, safe, and nutritious food to meet their dietary needs and food preferences for an active healthy life.” [1] A recent JAMA study reported that suboptimal intake of nutrients and healthy foods was associated with over 45% of deaths due to heart disease, stroke, or type 2 diabetes. [2] Yet for too many people, adequate access to nutritious food is out of reach. Some of these people live right in our community.

Photos courtesy of Loving Spoonful

The neighbourhoods in North Kingston make up 20% of the total population, and their average income is 22% lower than the city average. [3] The people living in North Kingston are twice as likely not to have completed high school, and twice as likely to be living on low incomes. [3] Many physicians that know their patients may not always be able to afford food ask their patients at appointments if they have enough food. Some family health teams even have an emergency supply cupboard in their office for extra food to give to patients who need it.

To increase awareness of these issues, we became closely involved in helping develop a service learning project in partnership with Loving Spoonful,  an organization that works to achieve a healthy, food-secure community. The project is structured around community cooking programs for low-income Kingston residents with medical students as volunteers. On top of building food literacy and confidence in preparing healthy foods among class participants, the goals of the project were to expose medical students to the Kingston community, provide information about food security in Kingston, and encourage them to create a dialogue with the participants in order to learn more about what they can do as future physicians.

The project also allows for students to accompany a physician from the Kingston Community Health Centres to visit the home of a patient living on a fixed income. The students have found that this experience has been eye-opening to appreciate firsthand the ways in which barriers can be specific to individuals. For example, if an individual has difficulty standing, the food s/he buys has to be prepared quickly, which limits his or her choices. Underpinning all of these experiences is a facilitated debrief and written reflection at the end, which allows students to share and document their insights, challenges, and surprises.

Ten medical students have participated in the service learning project thus far, with more students registered for this fall. All of the students have enjoyed this project in many aspects, from improving their own food preparation skills, to developing rapport with the local Kingston residents.

Overall, we are walking away with a greater appreciation for the social determinants of health. As future physicians, the social inequities that underlie many chronic diseases may seem insurmountable. However, this work is not solely our own. Organizations like Loving Spoonful play an important role in our community to address upstream factors that we eventually see presenting as illness. Being knowledgeable about the resources available in our community is a small but helpful step we can take to help our patients address challenging socio-economic circumstances.

Thank you to Loving Spoonful for your invaluable partnership in developing this project and the Kingston Community Health Centres health team for contributing to student learning. We would also like to gratefully acknowledge the City of Kingston and United Way for their Community Investment Fund, as well as the Kaufman Endowment fund, which helped fund this program.


References
[1] Committee of World Food Security
[2] Micha R, Penalvo JL, Cudhea F, Imamura F, Rehm CD, Mozaffarian D. Association between dietary factors and mortality from heart disease, stroke, and type 2 diabetes in the United States. JAMA 2017;317(9):912-924.
[3] Kingston Community Health Centres. A community needs assessment of North Kingston neighbourhoods. June 2010

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6th annual Medical Student Research Showcase

By Drs. Heather Murray & Melanie Walker

This year the School of Medicine is proud to invite you to the 6th annual Medical Student Research Showcase on Wednesday September 20th.

This event celebrates the research achievements of our undergraduate medical students, with both posters and an oral plenary session featuring research performed by students while they have been enrolled in medical school. All students who received summer studentship research funding through the School of Medicine in 2017 will be presenting their work, as well as many other research initiatives. The posters will be displayed in the David Walker atrium of the School of Medicine building from 8am until 5pm, with the students standing at their posters answering questions between 10:30 and noon.

The oral plenary features the top research projects selected by a panel of faculty judges, and will run in room 132A from noon until 1:30pm on September 20th, immediately following the poster session Q&A.

This year’s faculty judges included:

Dr. Yuka Asai

Dr. Jennifer Flemming

Dr. Katrina Gee

Dr. David Good

Dr. Dianne Groll

Dr. Paula James

Dr. Robert Reid

Dr. Prameet Sheth

Dr. Graeme Smith

Dr. Tan Towheed

Dr. Andrea Winthrop

We are very grateful to these faculty members for evaluating our oral plenary applicants this year.

The three students who have been selected for the oral plenary session, and the titles of their research presentations and faculty supervisor names are listed below. Each of these three students will receive The Albert Clark Award for Medical Student Research Excellence.

Gregory Hawley – Plasminogen depletion following severe burn injury

Jeffrey Mah – Survival following Transjugular Intrahepatic Portosystemic Shunt (TIPS) in Patients with Cirrhosis: A Population-based Study

Sean Tom – ETS1 transcription factor-mediated upregulation of microRNA-31 controls cardiac fibrogenesis in human atrial fibrillation.

Please set aside some time to attend the Medical Student Research Showcase on September 20th. The students will appreciate your interest and support, and you will be amazed at what they have been able to achieve.

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Teaching, Learning and Integration Committee Summer Update

By Lindsay Davidson, Director of Teaching, Learning, and Integration

As classes (at least in years 1 and 2) have now ended, and teachers are perhaps thinking about courses that will resume in the fall, I wanted to provide you with an update of items from the TLIC. Some of these may already be familiar to you, but perhaps some are “new”. If you need any further information, please feel free to contact me directly or one of our Educational Developers (Theresa Suart from Years 1 and 2 and Sheila Pinchin for Clerkship and the “C” courses).

  1. Resources attached to learning events – these include lecture notes, classroom slides, required pre-class readings and optional post-class readings/resources. MEdTech is enabling a new feature for the upcoming academic year. Teachers will be required to review and “publish” each resource every year – with the option of adding in delayed release if appropriate. The goal of this is to provide students with an up-to-date, curated set of resources, deleting old files. Please direct any questions about this to Dr. Lindsay Davidson.
  • Remember: “less is more”: Students report that when there are an excessive number of files, they often read few/none of them in advance.
  • Clearly designate what is MANDATORY to review PRE-CLASS by indicating this in the “Preparation” field on the learning event, and checking the appropriate boxes on the menu when you review the resources.
  • AVOID using dates on your slides/slide file names – students are sometimes disappointed to see that the file dates from 2009 or prior.
  1. The Curriculum Committee has approved a new learning event type – “Games” – reflecting several sessions already existing in the curriculum. This is defined as “Individual or group games that have cognitive, social, behavioral, and/or emotional, etc., dimensions which are related to educational objectives”. This type of activity might include classroom Jeopardy or other similar activities designed to allow students to review previously taught knowledge (content delivered either independently or in the classroom) and to provide them with formative feedback on their understanding. The instructional methods approved by the Curriculum Committee include:

Please direct any questions about this to Theresa Suart.

  1. Workforce – The Workforce Committee has recently adopted some changes including the following:
  • Addition of credit for teachers who grade short answer questions or team worksheets
  • Doubling of credit for teachers who develop new (or significantly renovate) teaching session
  • Limit of one named teacher per DIL event
  • Limit of one teacher per SGL event (gets additional credit to reflect session design, learning event completion, submission exam questions); additional teachers credited as tutors (credit for time in the classroom) – the Course Director may be asked to clarify who is the “teacher” and who is/are the “tutors”
  • Reduction of credit for large classroom sessions (that are not new/newly renovated and/or do not involve grading)

Please direct any questions about this to Dr. Sanfilippo.

  1. Tagging of Intrinsic Role objectives. The TLIC and the Intrinsic Role leads recently held a retreat. One of the items that was identified was “overtagging” of sessional objectives with intrinsic role objectives such as communicator, collaborator, professional etc. by well meaning teachers. We are undertaking a comprehensive review of how these Intrinsic Roles are taught/assessed in the curriculum and would ask teachers/course directors NOT to tag sessions with these unless there has been a direct communication with the relevant Intrinsic Role lead.

Please direct any questions about this to Dr. Lindsay Davidson.

  1. DIL feedback from students. Over the past year, we have received useful feedback from students regarding the content and structure of Directed Independent Learning (DIL) sessions in Years 1 and 2. This will be collated and communicated to Course Directors shortly. Theresa Suart will be in contact with teachers/Course Directors should any sessions be identified for review/revision.
  2. Online modules. We have developed a process to facilitate the development of high quality online modules, often used as resources in DIL session. These are highly appreciated by students and are used for review in clerkship as well as pre-MCC exam. The current list of modules is available here: https://meds.queensu.ca/central/community/ugme_ecurriculum If you would like to create (or revise) a module for your course, please complete the linked intake form: https://healthsci.queensu.ca/technology/services/elearning/online_learning_modules/get_help
  3. New wording of learning event notices. You may have noticed this over the past year. The wording of the 3 email notices received by teachers has been revised. In particular, it has been streamlined and customized to provide specific, focused reminders prior to the scheduled teaching. We would appreciate any feedback or suggestions that you have about this change.
  4. Video capture In 2016-17, lecture sessions were video captured in select year 1 and 2 classes. We will be analyzing how these videos were used by students over the summer and will likely be continuing this into the fall. Please provide any feedback or comments that you have about this pilot to Theresa Suart.

Feel free to get in touch:

 

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100+ Medical Students Who Care

By Dr. Melanie Walker, Course Director, Population & Global Health

Each first year class in Queen’s UGME embarks on the ‘Community Based Interventions Project’ (CBIP) as part of their Population and Global Health (PGH) course. The project provides students with an opportunity to gain insight into social and health services that serve patients in the greater Kingston community. The students learn about the importance of social determinants of health and patient context through the eyes of a special population that they are interested in exploring. This experience provides them with better insight into supports which affect the health and management of their future patients.

Outside of the medical school, I am a member of a local charity: 100+ Women Who Care Kingston. This organization consists of a group of Kingston-based women who meet four times a year to support non-profit and charitable organizations in our community. The principle is simple – any member is permitted to nominate one local organization per meeting. If this organization is chosen as one of three picked at random, the nominating member is allotted five minutes to speak to the membership to express why their particular organization is worthy of the group’s charitable donation and what that organization would do with the funding if received. The three nominees are then put to a vote by the membership and the majority wins. Over one hour, one worthy local organization receives a financial ‘boost’ of approximately $20,000. Simple…yet powerful.

In light of this, last year we initiated a new advocacy component to the PGH course through the CBIP – the opportunity, as a class, to nominate one of the researched organizations that they thought could benefit from an infusion of funding to address a gap in service identified by the organization. The class vote would become my vote at 100+ Women. Both the 2019 class and, just recently, the 2020 class overwhelmingly voted for the Sexual Assault Centre Kingston (SACK) to be brought forward to 100+ Women.

SACK is a “not-for-profit, charitable organization committed to free, confidential, non-judgemental support for all survivors of recent and/or historic sexual violence in Kingston, Frontenac, Lennox & Addington (KFL&A).” While it may not be surprising to learn that girls and young women between the ages of 15-24 are the most likely victims of sexual assault it was eye-opening to learn from our students that Kingston has the highest rate of sexual assault per capita in Canada. The majority of funding received by SACK is thus, understandably, directed at the support services with little left over for education and prevention. In fact, the Kingston Youth Sexual Violence Prevention Assessment put out a report in May of 2015 that stated “the Kingston community needed to engage youth before sexual & dating violence occurs. Organizations need to explicitly address important concepts including consent, healthy sexuality, healthy relationships, rape culture, alcohol & drug-facilitated sexual assault, and sexual violence.”

After six 100+ Women Who Care Kingston meetings and six attempts (between last year and this), the stars aligned on Feb 23, 2017 and SACK was the 3rd random pick of the night of the 30+ nominated charities.  The end result was an overwhelming majority vote of the 100+ women in the room to support this organization.  Two of the students from the class of 2019 that had an instrumental role in getting SACK nominated by their classmates, Tiffany Lung and Kate Liu, were present with me at the recent cheque-presenting ceremony by the leading ladies of 100+ Women Who Care Kingston to SACK on March 31st. The donation of $20,000+ will be directed at the development of a much-needed youth prevention program across the greater Kingston area which will include sexual assault resistance programming – the only evidence-based program that has been shown to significantly reduce the incidence of rape and other forms of sexual assault.

The night that SACK was voted to receive this donation I was approached by many community members who were not only impressed with the important work that SACK does but by the School of Medicine’s investment in teaching our physicians-in-training about the importance of population health and health advocacy. Amazing what can be accomplished when 100+ medical students who care connect with a local group of women who care to create an opportunity for change in our community.

The recent Whig Standard Article can be found here.

Many thanks to the following for making this possible:

  • Meds 2019 class (special thanks to Tiffany Lung, Kate Liu, Zoe Lau and Sallya Aleboyeh)
  • Meds 2020 class (special thanks to Alexandra Basden, Azraa Janmohamed, Denisha Puvitharan, Khatija Anjum, Sana Khan and Jagpreet Kaler)
  • 100+ Women Who Care Kingston and the leading ladies (special thanks to Lindsay Duggan)
  • Sexual Assault Centre Kingston (special thanks to Jennifer Byrd and Elayne Furoy)

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Building Bridges, Making Pathways

By Denisha Puvitharan (Meds 2020), Darsan Sadacharam (Meds 2020) and Sahra Nathoo (Meds 2019)

Twenty-four curious high school students joined the ranks of diligent medical students in the halls of the Medical Building on March 31st. These students were taking part in the first ever “Pathways to Medicine” event hosted by Queen’s School of Medicine’s Diversity Panel.

Through a new partnership with a local chapter of a national organization, Pathways to Education, the panel organized a full day event aimed at increasing interest in a future career in medicine among students engaged with Pathways, along with some students from Immigrant Services Kingston and Area (ISKA).

Participating students heard from Dr. Michelle Gibson, Director of Year 1, who introduced them to the day. They participated in a small group learning session with Dr. David Bardana and the class of 2020, clinical skills training with tutors Drs. Rick Rowland and Nicola Murdoch, and resuscitation simulation and laparoscopic training sessions with residents, Drs. Kristen Weeksink and Gary Ko, during their visit. Dr. Mala Joneja, Director of Diversity in UGME, sped them on their way with inspiring words. The inaugural “Pathways to Medicine” event was an excellent teaching and outreach event that was highly praised by all staff and students involved.

The Diversity Panel is an interdisciplinary team of interested students, educational staff and faculty, which exists to improve undergraduate medical education at Queen’s, through increasing diversity and making careers in medicine more accessible to those from underrepresented populations. There have been many conversations regarding the importance of medical student bodies representing the diversity of the patient communities they will serve in the future. In addition to the upstream effects of making the healthcare profession more adept in providing quality care to the existing diverse population, increased physician diversity is also particularly important when considering the physician shortages that low income neighbourhoods face in Canada. By enticing more students from these neighbourhoods to attend post-secondary education and medical school, there is an increased likelihood they will return to practice in these neighbourhoods, thus helping relieve some health inequities.

Though many efforts have been made to make medical school more accessible to students from lower socio-economic backgrounds, many barriers remain. The cost of medical school alone is astronomical, when considering the tuition for an undergraduate degree, MCAT registration fees, application fees, and potential income-earning hours spent studying; students from low income families are already discriminated against. Attempting to address these concerns, the Pathways to Medicine event also included a presentation on financing medical education by Ms. Margie Gordon from the Registrar’s Office, specifically regarding OSAP, grants and other resources available to help these students reach their goals.

However, when making efforts to increase the accessibility of medical school for students from diverse socioeconomic backgrounds, the true challenge is in leveling the playing field at the starting line for these students. From the onset of a student’s educational journey, his/her family’s financial and social resources can play a significant role in dictating their success. Strong financial support can assist a student’s ability to excel in school, while also participating in various extracurricular activities, which can benefit the student in future endeavours. Furthermore, students from higher socioeconomic backgrounds are privy to strategic knowledge of what it takes to become competitive applicants as a result of having access to various social resources. These resources can come in the form of connections with academics, physicians and others that have experience navigating the application system. An anecdotal example of how strong social resources can provide an advantage to students is provided by Dylan Hernandez’s opinion column in the NY Times.

“Pathways to Medicine” represents Queen’s UGME Diversity Panel’s continued efforts to find creative strategies in addressing this complex challenge. Although this may be a small step towards addressing these barriers, it is our hope that through events like this and other similar initiatives held at medical schools across Canada, students from diverse backgrounds may soon see medicine as a realistic goal.

 

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The Value of Medical History

By Sallya Aleboyeh, MEDS 2019

A group of passionate and curious medical students chose to venture to Ottawa on the Family Day weekend this past February. Instead of visiting their families, they dove into history, with a group of equally-passionate curators and assistant legislators to Elizabeth May who also gave up time to give us private tours of:

  • The Preservation Centre in Gatineau, which houses vaults filled with paintings, media and lots of important archives
  • Parliament
  • The Museum of Science and Technology’s Storage Facility (which is apparently cooler than the museum itself)

This year was the final time Dr. Jacklyn Duffin, Hannah Professor in the History of Medicine, organized the history of medicine trip, making the fate of future trips uncertain.  So instead of telling you how cool everything was (hopefully the photos can show that), I thought I’d share the value I see in keeping the tradition alive.

1. Cool Architecture: The Role of design, décor and architecture in medicine

(All photos by J. Duffin)

Arriving at our first stop, the Gatineau Preservation Centre, what stood out most was the architecture.  The vaults were inside a huge cement box that looked like the set of a parkour film; while the top floor, where restoration was done, resembled a Lego village complete with primary colour paints and street names for corridors.  Whether you cared about the science behind restoring artifacts or not, the design was very hard to ignore.

On a day-to-day basis, physicians not only interact with patients, but with their environment as well.  While it’s not practical or financially viable to have an architect design each hospital as a unique piece of art, the impact of space is large enough to warrant investing some thought.  There are already lots of examples of environment helping with patient or doctor experiences:

  • Having windows in the ICU rooms to help with delirium
  • Having paintings/magazines in waiting rooms to make wait times seem shorter
  • Having healing gardens to reduce stress for patients and health care workers
  • Having cartoon characters on walls in children’s hospitals
  • Having the nursing station in the middle of a room, visible to all patients, to reduce anxiety
  • Decorating your office with pictures of family to make working there more enjoyable.

(for more evidence of the importance of environment in health- check out this NYT article here!)

Obviously, during an emergency, it won’t matter how aesthetically pleasing the sheets or walls are, but the vast majority of hospital interactions with patients and among health care workers aren’t immediately urgent.  In these instances, a little interior design can work its subtle magic on people’s mood and their interactions because we all (I think) appreciate pretty things.  It’s why chefs create garnishes and why companies invest in packaging.  In the long run these small effects can add up to increase overall wellbeing and happiness.

2. Studying History is humbling and reminds you that your actions might outlive you

The Apology: Commemorates the legacy of the former Indian Residential School students and their families, as well as the Prime Minister’s historic Apology in 2008.

If you’ve ever been to a really old place, you’ll know that you get a strange surreal feeling, like you are experiencing something bigger than yourself (hopefully it’s not just me). When I was 16 and my mom took me to the ruins of Persepolis (wiki: “the ceremonial capital of the Achaemenid Empire”) and I felt it for the first time while trying to imagine what it looked like thousands of years ago before Alexander attacked it.  It reminds you at once of how insignificant you are and how capable you are of creating something that can last for generations after you are gone.

The profession of medicine can be demanding:  long hours, bad news, on call shifts, high stake decisions and emotional fatigue to name but a few.  It’s in these moments when remembering that you’re working towards something bigger helps.  One day when we’ve all left this planet, curators, historians and medical students may look through the ultrasound machines, pacemakers and lounge room coffee machines we used and try to uncover the story of our daily lives.  We can’t predict which of the thousands of items we see and use in our lifetime will survive as artifacts, but we can choose what kind of story they tell.

3. History is full of lessons and wisdom

Finally, most important of all is that history is an endless resource of wisdom and lessons.  We constantly look to our tutors, teachers and mentors for guidance for medicine because it’s easily accessible; but why stop there?

From history you can learn to be creative, and to draw inspiration from new places.  Over the course of the weekend, we saw multiple examples of technology from other industries being adapted to medicine.

  • The cloth used to make sails being used as a backing for fragile paintings
  • Ultrasound machines being used to detect aircraft defects and in the navy before being applied to medicine
  • The Fibroscan for the liver coming from cheese manufacturing (I technically learnt this in class after the trip but it helps prove the point)

History’s mistakes teach us to not just accept what we’ve been told but to dig deeper and ask questions because things may not be what they seem.  During our visit to the Storage room, the curator’s personal research on artifacts in the storage revealed that Sir William Osler – a great Canadian medical teacher – may have used the remains of aboriginal bodies for research purposes.  Another inquiry led the curator to discover that models of babies with syphilis were used to promote eugenics and not medical education as previously believed.  If we remain passive in our learning and acceptance of new information, it’s often the patient who will pay the price.

(In conclusion) I hope there will be many more history of medicine trips to come because there is still a lot that history can teach us (and lots of cities to be seen) before we begin our practices.


A version of this blog post appeared previously on the Medicine and Literature blog. Find it here. Thanks to Sallya Aleboyeh for her permission to repost it here.

 

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History of Medicine week highlights psychiatry

Dangerous Ideas in the History of Psychiatry is the theme of this year’s History of Medicine week here at Queen’s UGME.

Highlights for the week include a panel discussion with speakers from Queen’s, York University, and University of Toronto and an artifact showcase.

The Panel Discussion will take place on Wednesday, March 8 from 5 – 7 p.m. in Room 132 of the Medical Building on Arch Street; refreshments will be served.

Panelists will include:

Dr. Megan Davies, York University

  • “Messy History: Democratising the Story of Deinstitutionalization”

Dr. Edward Shorter, University of Toronto

  • Dangerous Ideas in the History of Psychiatry: ‘Hysteria’”

Prof. Steven Maynard, Queen’s University

  • Just Who Are You Calling a Dangerous Sexual Psychopath?: Psychiatry and the History of Homosexuality in Canada”

The Artifact Showcase will be found in the Medical Building Atrium on Thursday, March 9 from 9 a.m. – 3p.m. This drop-in exhibit will feature items from the history of psychiatry curated by the Museum of Health Care.

Both events are open to the public.

A student committee organized the week, supported by the School of Medicine and the Museum of Health Care. Student organizers included Ashna Asim, Yannay Khaikan, Harry Chandrakumaran, Chantal Valiquette along with executive members Daisy Liu, Hissan Butt and Laura Swaka. Dr. Jacklyn Duffin, Hannah Professor of the Hannah Chair in the History of Medicine at Queen’s, served as their faculty advisor.

 

 

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