Tuesday, November 6, 2012
Passing through gastroenterology and hepatology
Somehow we've already made it through two blocks of our M2 year. How can we slow time down? I'm not ready to be this close to the boards!
GI was another five-week block and ran similarly to the last three blocks [Renal, Cardiovascular, Respiratory, and Neuroscience was an outlier.] We had one TBL, weekly quizzes, labs and lecture. Our final grade was determined from our performance on quizzes, TBL, a physiology podcast assignment [see below for details], Anatomy practical and final exam.
What I loved
Course Directors. When the course directors for the course insist on being at almost every single lecture, it really sets a positive tone. This is especially important for when we have questions about the material or the nitty-gritty about the course itself because we know we can rely on seeing our course directors in lecture.
Option for Weekly Review. In previous blocks, we had time set aside for a weekly review on Fridays. For GI, Dr. Harriott made a little lockbox for students to submit questions for the weekly review. If we had no questions that week, there was no review. I really liked this format since it meant that professors/clinicians would only have to come in if there was a need. Sometimes I felt bad that time would be taken out of their busy schedule to come to a review that might be sparsely attended; the option for submitting a question helped prevent this from happening.
Final Exam. NBME exams are wonderful. Really.
What I felt neutral about
Anatomy Practical. In Cardio and Pulmonary, the anatomy practicals weren't something I stressed myself over because they were straightforward and I knew how to study for them. But this year, we have new anatomy professors and a new style of practical exam. While I wasn't as disappointed with the GI practical as I was for the Renal one, I was still a bit perplexed by why one-third of the exam was histology. I understand that in medicine, integration is key and welcome some variety in questions, but in the past, histology was never more than a few questions or maybe ~10% of the exam. The sudden focus on histology really caught me off-guard. In the end, I can grow to appreciate the additional variety in questions, but I wish there was consistency in the exams so that once I've figured out the most appropriate way to study, I can stick to it. (This is the beauty of NBME exams, many if not most of us study from First Aid Organ Systems and consistently do well).
What could be improved
Physiology Podcast Assignment. In lieu of a normal physiology lecture, we created a Podcast lecture and a handout within our TBL groups covering a small topic. Our group's topic was the GI reflexes [e.g. gastro-colic] and their possible influence on diarrhea in irritable bowel syndrome (IBS). After creating a presentation and a handout, then recording it, each individual had to take a 10 question quiz on the material. Additionally, we were expected to provide feedback on other teams' work through an online forum.
I think that this assignment has enormous potential as a learning tool but that the way that it was executed this block, made it more of a burden than anything else. The making of the podcast took a pretty significant chunk of time, but it definitely hammered the material into our head. The quiz didn't really seem to correlate with the material presented in the podcasts, so it was frustrating to take. And it wasn't very clear as to how much feedback we were expected to provide through the online forums (i.e. did we have to comment on all 10 podcasts or just a few?).
Overall, I think that this activity/assignment could be a great learning tool but that it needed clearer expectations and the questions created directly from the material presented by each group.
100% of the class passed in both the Renal and GI NBME final exams. I think this is a good sign.
Dr. Cappell and Dr. Harriott did a wonderful job with this block and I applaud them for their hard work and dedication to making it a success!
Amanda Xi, ACP Medical Student Member, is a first-year medical student at the OUWB School of Medicine, charter class of 2015, in Rochester, Mich. She has a Bachelor of Science in Engineering [Biomedical Engineering] and Master of Science in Engineering [Biomedical Engineering, again] from the University of Michigan. This post originally appeared at her blog, "And Thus, It Begins," which chronicles her journey through medical training from day 1 of medical school.
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Members of the American College of Physicians contribute posts from their own sites to ACP Internistand ACP Hospitalist. Contributors include:
Albert Fuchs, MD, FACP, graduated from the University of California, Los Angeles School of Medicine, where he also did his internal medicine training. Certified by the American Board of Internal Medicine, Dr. Fuchs spent three years as a full-time faculty member at UCLA School of Medicine before opening his private practice in Beverly Hills in 2000.
And Thus, It Begins
Amanda Xi, ACP Medical Student Member, is a first-year medical student at the OUWB School of Medicine, charter class of 2015, in Rochester, Mich., from which she which chronicles her journey through medical training from day 1 of medical school.
Ira S. Nash, MD, FACP, is the senior vice president and executive director of the North Shore-LIJ Medical Group, and a professor of Cardiology and Population Health at Hofstra North Shore-LIJ School of Medicine. He is Board Certified in Internal Medicine and Cardiovascular Diseases and was in the private practice of cardiology before joining the full-time faculty of Massachusetts General Hospital.
Zackary Berger, MD, ACP Member, is a primary care doctor and general internist in the Division of General Internal Medicine at Johns Hopkins. His research interests include doctor-patient communication, bioethics, and systematic reviews.
Controversies in Hospital
Run by three ACP Fellows, this blog ponders vexing issues in infection prevention and control, inside and outside the hospital. Daniel J Diekema, MD, FACP, practices infectious diseases, clinical microbiology, and hospital epidemiology in Iowa City, Iowa, splitting time between seeing patients with infectious diseases, diagnosing infections in the microbiology laboratory, and trying to prevent infections in the hospital. Michael B. Edmond, MD, FACP, is a hospital epidemiologist in Iowa City, IA, with a focus on understanding why infections occur in the hospital and ways to prevent these infections, and sees patients in the inpatient and outpatient settings. Eli N. Perencevich, MD, ACP Member, is an infectious disease physician and epidemiologist in Iowa City, Iowa, who studies methods to halt the spread of resistant bacteria in our hospitals (including novel ways to get everyone to wash their hands).
db's Medical Rants
Robert M. Centor, MD, FACP, contributes short essays contemplating medicine and the health care system.
Suneel Dhand, MD, ACP Member
Suneel Dhand, MD, ACP Member, is a practicing physician in Massachusetts. He has published numerous articles in clinical medicine, covering a wide range of specialty areas including; pulmonology, cardiology, endocrinology, hematology, and infectious disease. He has also authored chapters in the prestigious "5-Minute Clinical Consult" medical textbook. His other clinical interests include quality improvement, hospital safety, hospital utilization, and the use of technology in health care.
Juliet K. Mavromatis, MD, FACP, provides a conversation about health topics for patients and health professionals.
Dr. Mintz' Blog
Matthew Mintz, MD, FACP, has practiced internal medicine for more than a decade and is an Associate Professor of Medicine at an academic medical center on the East Coast. His time is split between teaching medical students and residents, and caring for patients.
Toni Brayer, MD, FACP, blogs about the rapid changes in science, medicine, health and healing in the 21st century.
Vineet Arora, MD, FACP, is Associate Program Director for the Internal Medicine Residency and Assistant Dean of Scholarship & Discovery at the Pritzker School of Medicine for the University of Chicago. Her education and research focus is on resident duty hours, patient handoffs, medical professionalism, and quality of hospital care. She is also an academic hospitalist.
John H. Schumann, MD, FACP, provides transparency on the workings of medical practice and the complexities of hospital care, illuminates the emotional and cognitive aspects of caregiving and decision-making from the perspective of an active primary care physician, and offers behind-the-scenes portraits of hospital sanctums and the people who inhabit them.
Ryan Madanick, MD, ACP Member, is a gastroenterologist at the University of North Carolina School of Medicine, and the Program Director for the GI & Hepatology Fellowship Program. He specializes in diseases of the esophagus, with a strong interest in the diagnosis and treatment of patients who have difficult-to-manage esophageal problems such as refractory GERD, heartburn, and chest pain.
Mike Aref, MD, PhD, FACP, is an academic hospitalist with an interest in basic and clinical science and education, with interests in noninvasive monitoring and diagnostic testing using novel bedside imaging modalities, diagnostic reasoning, medical informatics, new medical education modalities, pre-code/code management, palliative care, patient-physician communication, quality improvement, and quantitative biomedical imaging.
William Hersh, MD, FACP, Professor and Chair, Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, posts his thoughts on various topics related to biomedical and health informatics.
David Katz, MD
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Richard Just, MD, ACP Member, has 36 years in clinical practice of hematology and medical oncology. His blog is a joint publication with Gregg Masters, MPH.
Kevin Pho, MD, ACP Member, offers one of the Web's definitive sites for influential health commentary.
Michael Kirsch, MD, FACP, addresses the joys and challenges of medical practice, including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When he's not writing, he's performing colonoscopies.
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Alexander M. Djuricich, MD, FACP, is the Associate Dean for Continuing Medical Education (CME), and a Program Director in Medicine-Pediatrics at the Indiana University School of Medicine in Indianapolis, where he blogs about medical education.
Rob Lamberts, MD, ACP Member, a med-peds and general practice internist, returns with "volume 2" of his personal musings about medicine, life, armadillos and Sasquatch at More Musings (of a Distractible Kind).
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Kimberly Manning, MD, FACP, reflects on the personal side of being a doctor in a community hospital in Atlanta.
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Paul Sufka, MD, ACP Member, is a board certified rheumatologist in St. Paul, Minn. He was a chief resident in internal medicine with the University of Minnesota and then completed his fellowship training in rheumatology in June 2011 at the University of Minnesota Department of Rheumatology. His interests include the use of technology in medicine.
Technology in (Medical)
Neil Mehta, MBBS, MS, FACP, is interested in use of technology in education, social media and networking, practice management and evidence-based medicine tools, personal information and knowledge management.
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Other blogs of note:
American Journal of
Also known as the Green Journal, the American Journal of Medicine publishes original clinical articles of interest to physicians in internal medicine and its subspecialities, both in academia and community-based practice.
A collaborative medical blog started by Neil Shapiro, MD, ACP Member, associate program director at New York University Medical Center's internal medicine residency program. Faculty, residents and students contribute case studies, mystery quizzes, news, commentary and more.
Michael Benjamin, MD, ACP member, doesn't accept industry money so he can create an independent, clinician-reviewed space on the Internet for physicians to report and comment on the medical news of the day.
The Public Library of Science's open access materials include a blog.
One of the most popular anonymous blogs written by an emergency room physician.