Adjusting to Medical School

Adjusting to a new environment never comes easily. Our bodies will eventually adapt to seasonal climate changes, travelling to different time zones, or high altitude, but it invariably takes some time, and involves a little discomfort along the way. Adjustments of any kind are easier if anticipated and understood in advance.

Medical school is an adjustment and, unfortunately, not always anticipated by those “taking the plunge”.

What’s the most difficult adjustment for first year medical students?

Asked that question, most would point to issues such as workload, engaging initial patient encounters, or perhaps aspects of technical competence involving physical examination or procedures. All important, to be sure, but these challenges are understood in advance, anticipated by our curriculum, and well within the abilities of the young people entering medicine, who are already very accomplished and have engaged the process and been selected with all these issues firmly in mind.

Beyond these anticipated challenges, there are other adjustments that are even more critical to success but much less well-appreciated or even unanticipated by students.

 

Changing Purpose

Why do we undertake educational programs? For many undergraduate university students, it is to either to pursue an area of personal interest, or to achieve prerequisites or qualification for a subsequent program. That’s certainly the case for students contemplating entry to medical school. These are certainly worthy goals, but they are personal and intended to promote individual objectives. In a professional program such as medicine, the goals of learning shift to encompass the interests of other parties, specifically future patients. The approach and motivation for learning must also shift. In the words of an astute former mentor “Medicine is a service industry”. Medical school is about preparing young people to provide that service. The learning is facilitated by that goal. In fact, it can’t occur without it.

 

Seeking validation

Students entering medical school have achieved much recognition for their academic and personal accomplishments, the most recent and notable being their success in the admission process. As they undertake their studies together with equally accomplished classmates and in a system that defines success simply as “pass” with very little numerical grading, external kudos and other tangible evidence of success become increasingly rare. The perception of success must therefore shift from the external to internal as will, eventually, the responsibility for ensuring they remain knowledgeable and technically competent.

 

The expectation of professional behaviour

Medical education is patient-centred. Students learn early that their interactions with patients must be carried out with high standards of confidentiality, respect and personal behaviour. Although that expectation is easily understood within the patient contact itself, it is perhaps less immediately understood that the same expectations are in play with all their interpersonal and social interactions. The lines between their personal and student lives therefore become blurred. For most, this is a novel experience, and perhaps the first realization of what it means to have engaged a professional role.

 

Dealing with uncertainty

Students, particularly those from backgrounds in the physical or biologic sciences, have come to expect precision and certainty in their studies. The concept of “right” and “wrong” provides reassuring clarity and promotes the expectation that learning is a finite endeavor, culminating with the discovery of that single, correct response. In the study of medicine, they find a much less dichotomous world where many clinical issues are nuanced and require interpretation based on many variables. They must develop “approaches” based on “best evidence” always contextualized to the “patient’s unique circumstances”. For those accustomed to singular solutions, this can be quite unsettling.

 

All this can sound quite daunting but, like any life adjustment, will be eased with patience and support. Fortunately, much support is available. The quick “bonding” with classmates allows for the comforting realization that these challenges are not unique or some critical personal shortcoming, but rather ubiquitous features of the early medical school experience. Interactions with upper class colleagues, both planned and informal, provide further validation. Our Student Affairs programs, mentor groups, observerships and Clinical Skills groups all provide opportunities to discuss transition difficulties.

In the end, the adjustment is not merely about engaging a new educational program, but rather a more clearly defined identity and perspective of one’s role in the world.

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MD Program Executive Committee Meeting Highlights: September 18, 2018

By Jennifer Saunders

Faculty and staff interested in attending MD PEC meetings, should contact the Committee Secretary (Orser, Faye A. <Faye.Orser@kingstonhsc.ca>) for information relating to agenda items and meeting schedules.

UPDATE: 

The following revised Policies and Terms of Reference were discussed and approved by the Committee but require final approval by SOMAC.

  • Student Assessment Policy Revisions
  • QuARMS Admission Process
  • MD Program Progress & Promotion Committee TOR
  • P&P Policy and Student Professionalism Policy
  • MD Program Professionalism Advisory Committee TOR

The following policy was approved by the Committee:

  • The Attendance and Absences in Undergraduate Medical Education Policy
    • Supersedes: Policy #SA-07 v3

This policy is effective October 1, 2018.

All Undergraduate Medical Education policies and terms of reference are available on the UGME website:  https://meds.queensu.ca/academics/undergraduate/policies-committees

 

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Fourth Annual Pap Party event set for October 15-18

By Lauren Wilson (MEDS 2019, Katherine Rabicki (MEDS 2019), Ariba Shah (MEDS 2020) and Hayley Manlove (MEDS 2021)

The fourth annual Pap Party event will take place October 15-18th, during Cervical Cancer Awareness week. This is an event which runs free pap smear clinics, specifically intending to reach women who may not have access to cervical cancer screening otherwise and to increase awareness of Human Papilloma Virus in the community.

In 2015, Cancer Care Ontario estimated that 26% of screen eligible women were overdue for their pap smear. Ensuring adequate access to all women and minimizing barriers to receiving screening are crucial; a Pap Party priority. In 2017, across all four clinic dates, 30 women received pap smears through the Pap Party campaign.

Women aged 21-70 who have not had a pap smear in the last three years are welcome. To increase accessibility to cervical cancer screening, women without primary care physicians, with or without a valid health card are also encouraged to attend the Pap Party Event.

The clinics are run by a team of medical students, residents and physicians under the guidance of Dr. Julie Francis and Dr. Hugh Langley and in collaboration with the Federation of Medical Women of Canada (FMWC). The first Pap Party in 2015 took place in Kingston and has since grown to offer clinics in Belleville, Napanee, and Tyendinaga as well.

The 2018 Pap Party schedule is :

Monday October 15 5:30pm – 7:30pm: HPE Public Health, Belleville

Tuesday October 16 5:30pm – 7:30pm: Community Well Being Centre, Tyendinaga, Mohawk Territory

Wednesday October 17 5:30pm – 7:30pm: Kingston Health Science Centre, Burr 1, Kingston

Thursday October 18 5:30pm – 7:30pm: Kingston Community Health Center, Napanee

To expand Pap Party further and combat declining cervical cancer screening rates, we have also reached out to all primary care clinics in the Kingston area encouraging them to host their own pap smear clinics during Cervical Cancer Awareness Week. They will also be encouraged to offer the HPV Vaccine. Clinics that register with the FMWC receive a kit that includes a tip sheet, colour poster, news release template, and patient education brochures. To register your clinic and contribute to reducing cervical cancer rates, please visit https://fmwc.ca/events/pap-campaign/.

The FMWC website also has more information for individuals and will help them find a registered clinic nearby.

Thank you taking the time to learn about the Pap Party initiative. Please feel free to contact us if you would like any additional information and please spread information about the Pap Party event to women in your life! We would be grateful and thrilled!

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Medical Student Research Showcase September 20

By Drs. Heather Murray & Melanie Walker

This year the School of Medicine is proud to invite you to the 7th annual Medical Student Research Showcase on Thursday September 20, 2018.

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 2018 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 8 am until 5 pm, 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 1:30 pm on September 20, immediately following the poster session Q&A.

This year’s faculty judges included:

Dr. Stephen Pang

Dr. Sheela Abraham

Dr. Nishardi Wijeratne

Dr. Faiza khurshid

Dr. Graeme Smith

Dr. Olga Bougie

Dr. Susan Crocker

Dr. Michael Rauh

Dr. Prameet Sheth

Dr. Yuka Asai

Dr. Thiwanka Wijeratne

Dr. Jennifer Flemming

Dr. Anne Ellis

Dr. Tim Phillips

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.

Harry Chandrakumaran – Inter-Laboratory Variability Of Parathyroid Hormone: impact on clinical decision-making
Sachin Pasricha – Clinical indications associated with opioid initiation for pain management in Ontario, Canada: A population-based cohort study
Rachel Oh – Evaluation of ARHGAP33 missense alleles in a zebrafish model of childhood glaucoma

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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Improving teaching, one slide at a time…

“How many slides can I have in my PowerPoint presentation?”

This is one question I get a lot as an educational developer, with a quick follow-up one about what’s the best way to put slides together.

Soon after it was first released in 1987, PowerPoint became both a boon and bane for teaching. (There are other software programs; PowerPoint just has well over 90% of the market). Computer program presentation software is certainly way more convenient than its predecessor overhead projector (and the accompanying slippery stack of slides), but it’s perpetuated some of the previous challenges with ill-conceived overhead transparencies while creating its own new issues.

Like how many slides is too many?

The standard advice is the 10/20/30 rule: 10 slides for a 20-minute presentation with 30-point font. This avoids the too-much issue: too many slides and too much information crowded on a single slide, but it’s simplistic advice that may not address your actual concerns.

I use four guiding questions to think about presentation slides:

  1. How are you going to use them?

  2. How are your learners going to use them?

  3. What else are you going to provide?

  4. Have you addressed the issues? (Accessibility, Copyright, Confidentiality, etc.)

 

How are you going to use them?

For example, are you using your slides as “attention getters” or information notes? Do you need an eye-catching image, or clear bullet points, or both? Are your images essential illustration, or distracting add-ons? If you’re showing a complicated image, is it to show “it’s complicated” or is it for detailed discussion and deeper learning?

How are your learners going to use them?

Take a step back and think about how your slides look projected on the three screens in the teaching theatres. Are your slides overwhelming or illuminating? Are your learners going to take notes on their electronic copy of your slides while you talk? Will these be their primary reference? Are your slides “must use” or “nice to have”?

What else are you going to provide?

Do you provide an electronic copy of your slides, before or after class? Are they complete or are there things omitted in your MEdTech published versions (either for pedagogical or other reasons, see next point!). If you’re using more visual versus text sides, are you providing accompanying notes? Do the students have other resources?

Have you addressed the issues? (Accessibility, Copyright, Confidentiality, etc.)

Issues about accessibility, copyright and confidentiality will vary based on particular circumstances. The best rule for layout is “keep it simple” – many of the built-in templates in programs don’t translate well to the screen and can be impossible to read for some people with particular vision problems. There can be issues of copyright for images – some things can be shown in class, but not saved to our learning management systems, for example. (And we have a copyright specialist here at Queen’s – Mark Swartz – who can help us navigate this). Also, regarding confidentiality, if screenshots of x-rays are used, for example, how is identifying information removed?

 

There are a vast number of resources online and multiple great reference books with tips and techniques for improving your use of presentation software. There is no single school of thought of best practices for teaching with this tool (although there are definitely pitfalls to avoid).

If you’re looking to improve your use of PowerPoint in the classroom, please feel free to get in touch. We can look at what you’re doing now, what your goals are, and talk strategies for changing things up as needed.

Meanwhile, if you have 14 slides for a 20-minute presentation, you’re likely ok. But if you’re planning 200 slides for a 50-minute lecture, chances are, that’s too many. Call me.

Reach me at theresa.suart@queensu.ca

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Welcoming Queen’s Meds 2022

At precisely 1 p.m. on Monday, November 6th 1854, Dr. James Sampson rose to address the twenty-three students who would become the first medical class entering the Queen’s School of Medicine. They were gathered in an upper room of a former military infirmary at 75 Princess Street, a building that still stands today, currently the site of a popular local hardware store.

Dr. Sampson, an Irish and British trained former military surgeon who was instrumental in the development of Kingston

Dr. James Sampson

General Hospital and would go on to serve multiple terms as Mayor of Kingston, was Professor of Clinical Medicine and Surgery. He was also President (essentially the first Dean) of the medical school. He introduced himself and his five colleagues who would form the first teaching faculty and then turned the podium over to Dr. John Stewart, Professor of Anatomy, Physiology and Practical Anatomy, who would deliver the first lecture.

In his book “Medicine at Queen’s: A Peculiarly Happy Relationship”, the late Dr. Tony Travill describes the event in vivid detail.  He notes that the room in which they met was “deplorably filthy”, but appearances did not deter the faculty members who felt appearances did not matter much “as there are no bacteria then in Kingston” meaning, presumably, there was no epidemic or plague currently active.

In that inaugural address Dr. Stewart spoke of “the importance of anatomy and physiology to the proper practice of surgery and medicine”. He went on to quote Galen who described anatomy as “the most beautiful hymn which man can chant in honor of his creator”. In finishing “He recounted the events leading to the school’s founding and exhorted the students to recognize that their future success depended more on themselves than on their professors: the only barrier to that success was idleness.”

Last week, Dr. Sampson’s successor, Dr. Richard Reznick, welcomed the one hundred and sixty-fourth group to be welcomed to their studies and to the profession by their faculty. Dr. Reznick challenged them to be restless in the pursuit of their goals and the betterment of our patients and society.

Photo by Lars Hagberg

.

A few facts about our new colleagues:

They were selected from a pool of 4836 highly qualified students who submitted applications last fall.

Of the 104 students the average age is 24 years.  Forty-nine members of the class are women and 55 are men. They hail from no fewer than 43 communities across Canada, including; Alma, Belleville, Brampton, Burlington, Cambridge, Dundas, Etobicoke, Golden Lake, Guelph, Kingston, Lively, London, Maple, Markham, Milton, Mississauga, Nepean, Nobleton, North York, Oakville, Odessa, Ottawa, Peterborough, Richmond Hill, Sarnia, Scarborough, Sittsville, Thornhill, Toronto, Whitby, Edmonton, Leduc, Calgary, Vancouver, Maple Ridge, Victoria, Coquitlam, West Vancouver, North Vancouver, Winnipeg, St John’s, New Minas, Halifax.

Eighty-six of our new students have completed an Undergraduate degree, and sixteen have postgraduate degrees, including three PhDs. The universities they have attended and degree programs are listed below:

Universities of Undergraduate Studies

Acadia University
Brown University
Carleton University
Harvard University
McGill University
McMaster University
Queen’s University
Quest University
Ryerson University
Simon Fraser University
St. Francis Xavier University
Trent University
University of Alberta
University of British Columbia
University of Calgary
University of Guelph
University of Ottawa
University of Toronto
University of Victoria
University of Waterloo
University of Ontario Inst. Of Tech
Western University
Wilfred Laurier University
York University

 

Undergraduate Degree Majors

Administration
Anatomy and Cell Biology
Biochemistry
Biochemistry and Molecular Biology
Biological Science
Biology
Biomedical Discovery and Commercialization
Biomedical Science
Chemical and Physical Biology
Chemical Biology
Chemical Engineering
Chemistry
Computer Science and Biology
English Language and Literature
Epidemiology and Biostatistics
Foods and Nutrition
Gender Studies
Global Experience
Health and Disease
Health Sciences
Health Studies
Integrated Science
Kinesiology
Kinesiology and Health Science
Knowledge Integration
Life Physics
Life Sciences
Mathematics and Physics
Medical Health Informatics
Medical Sciences
Molecular Biology and Genetics
Neuroscience
Nursing
Nutritional Sciences
Occupational and Public Health
Pharmacology
Physiology
Policy Studies
Psychology

An academically diverse and very qualified group, to be sure.  Last week, they undertook a variety of orientation activities organized by both faculty and their upper year colleagues.

On their first day, they were called upon to demonstrate commitment to their studies, their profession and their future patients.  They were assured that they will have a voice within our school and be treated with the same respect they are expected to provide each other, their faculty and all patients and volunteers they encounter through their medical school careers.  In addition to Dr. Reznick, they were welcomed by Ms. Rae Woodhouse, Asesculapian Society President, who spoke on behalf of their upper year colleagues, and Dr. Rachel Rooney provided them an introduction to fundamental concepts of medical professionalism.

Over the course of the week, they met curricular leaders who will particularly involved in their first year, including Drs. Michelle Gibson and Lindsey Patterson (Year 1 Directors) and Drs. Cherie Jones and Laura Milne (Clinical Skills Directors).  They were also introduced to Dr. Renee Fitzpatrick (Director of Student Affairs) and our excellent learner support team, including Drs. Martin Ten Hove, Jason Franklin, Kelly Howse, Mike McMullen, Josh Lakoff, Craig Goldie and Erin Beattie, who oriented them to the Learner Wellness, Career Counseling and Academic Support services that will be provided throughout their years with us.  They met members of our superb administrative and educational support teams led by Jacqueline Findlay, Jennifer Saunders, Theresa Suart, Amanda Consack, and first year Curricular Coordinator Corinne Bochsma.

Dr. Susan Moffatt organized and coordinated the very popular and much appreciated “Pearls of Wisdom” session, where fourth year students nominate and introduce faculty members who have been particularly impactful in their education, and invite them to pass on a few words of advice to the new students.  This year, Drs. Dale Engen, Debra Hamer, Ingrid Harle, Annette Hay, Michael Leveridge, Joseph Newbigging, Louise Rang and Andy Thomas were selected for this honour.

On Friday, the practical aspects of curriculum, expectations of conduct and promotions were explained by Drs. Michelle Gibson and Lindsey Patterson.

Their Meds 2020 upper year colleagues welcomed them with a number of formal and not-so-formal events.  These included sessions intended to promote an inclusive learning environment, as well as orientations to Queen’s and Kingston, introductions to the mentorship program, and a variety of evening social events which, judging by appearances the next morning, were much enjoyed.

For all these arrangements, flawlessly coordinated, I’m very grateful to Rebecca Jozsa, our Admissions Officer, Admissions Assistant Rachel Bauder, and to Rae Woodhouse and her second year colleagues.

I invite you to join me in welcoming these new members of our school and medical community, and end with a quote Dr. Reznick shared with the incoming class, drawn from his favourite poet and recent Nobel Laureate Bob Dylan:

May your heart always be joyful
May your song always be sung
And may you stay forever young

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