The Ultimate Christmas Wish List

The holiday season is here again! If you’re a normal person, you’re shopping for gifts, watching Christmas movies and spending time with family and friends. If you’re a graduate student, like I am, you’re eyeing the happy carefree people at Starbucks, sipping their peppermint mochas, as you sink deeper into your hoodie to study. But all good finals come to an end and soon you too will get a much‐needed break and a chance to kick back with family and friends! Here’s a list of a few great gifts to get the graduate student in your life (or buy them for yourself!).

1. Giant microbes (Drew Oliver) Recreating the world’s most virulent pathogens as plush, cuddly bedpals-­ what a concept! Choose from Flesh Eating Strep Pyogenes, West Nile Virus and Salmonella, among many others! Giardia’s pretty cute. Sure, a teddy bear is nice but does it come with fimbriae capable of adhering and unleashing gastroenteritis and neonatal meningitis, like E. Coli does? I think not. 

2. Occam’s Razor (Nerdcore) Occam’s Razor, or selecting the hypothesis that makes the fewest assumptions, is an important principle in making a medical diagnosis, one you’ve no doubt heard a professor throw out as he or she encourages you to think of horses not zebras when you hear hoofbeats! Sharpen your diagnostic skills with this card game by matching key symptoms to a diagnosis! It can be played in many ways (solitaire style, gin rummy, SPOONS, among others), with any number of players and all skill levels!

3. Anatomy Coloring Book (Wynn Kapit) Much of the healthcare student’s creative energy goes into finding a great mnemonic; how dutifully we’ve all learned that Randy Travis Drinks Cold Beer! This is another way to learn the brachial plexus. Filled with page after page of beautiful illustration, this book is a creative, low stress way to brush up on your anatomy or prepare for a course. Who said coloring was just for kids?

4. EMS Monopoly (Hasbro) As if life isn’t stressful enough. Take a whirlwind ride down Intubation Intersection and Hemmorhage Highway as you race against other EMTs, medics and responders to save patient lives (while commanding as many EMS stations and hospitals as possible). Just try to avoid being sent to jail for falsifying your credentials!

5. A great book: It is difficult to imagine medicine differently than it is practiced today but almost every aspect of medicine, from ethics to training, has a rich history behind it. Curl up with a great book this winter break and learn a bit more about the rich heritage of which we’re a part.

William Osler: A Life in Medicine (Michael Bliss) Considered by many to be the father of modern medicine, William Osler shaped many aspects of medical education today, from bedside learning to the creation of the medical residency. Learn about American medicine at the turn of the century (it was once thought that most of the graduating class of Harvard Medical School couldn’t even read!) and William Osler’s lifelong contribution to it.

Harvey Cushing: A Life in Surgery (Michael Bliss) A contemporary of Osler’s at Johns Hopkins, Cushing is in turn considered the father of modern neurosurgery. Tackling cases deemed hopeless by the science of the day, Cushing dramatically improved survival for many intracranial tumors, and he revolutionized American medicine by introducing blood pressure measurement.

The Emperor of All Maladies: A Biography of Cancer (Siddhartha Mukherjee) The author weaves skillfully through generations, empires and schools of thought to present a comprehensive history of cancer. The book is indeed a biography of this ancient malady, discussing how it has changed over time and how we have changed in our understanding and treatment of it.

Other great books: The Immortal Life of Henrietta Lacks (Rebecca Skloot) The Spirit Catches You and You Fall Down (Anne Fadiman)

I hope you find something on this list that piques your interest and I wish everyone the happiest and safest of holidays! 

Marsha Kocherla is a second-year medical student in Augusta. Her interests include poetry, yoga and classic movies!

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Let's Talk About Regional Campuses!

The time has come to decide where the M2s want to do their clinical rotations next year. In light of that little application burning a hole in our inboxes, here is the down and dirty about the three clinical campuses in question: Rome, Savannah, and Albany.

(First years, don’t start worrying about this yet but keep reading to get a taste of these “regional campuses” you’ve probably heard about by now.)

Rome (NW):

Rome’s curriculum is a special one, which I believe most of us find intriguing, but also slightly terrifying.  Thinking about being bounced from specialty to specialty every week and having to take all the shelf exams at once can make even the most confident medical student feel unsettled. However, Rome’s longitudinal curriculum seems to boast the best method for retention of clinical knowledge and skills of each specialty. 

Switching from Peds to Psych to Neuro etc. forces you to repeatedly retrieve the information you have amassed so that your newfound expertise never gets the chance to degrade completely (as we frustrated medical students know happens at an alarmingly rapid rate). However sometimes constant repetition in a compact period produces the best results, and so Rome has four-week intensive rotations in Surgery and OBGYN, where you can become a suturing master in no time. 

As for the shelves deal, well that week will be abysmal no doubt. Our helpful students up in Rome let us know that the best approach to taking the shelves in this manner is to study for this week as if it was for Step 2. They also alluded to the fact that this made studying for Step 2 a bit easier, which is supported by their impressive CK and CS scores as a group. In addition, Rome students’ shelf scores were higher on average to Augusta’s, which is reassuring. 

Lastly, the faculty in Rome has come from all over the country and is friendly, knowledgeable and eager to teach bright-eyed students like us. This combined with the impressive hospitals and remote beauty of Rome as a city, it would be a pleasure to spend clinical years at the NW campus.

Savannah (SE):

Savannah’s regional campus trip was optional, which I think says a lot about the immediate appeal of this campus to most of us. Around 80 of us made the trip and thoroughly enjoyed ourselves in one of the most beautiful cities in the Southeast. To get down to it, Savannah would be a wonderful place to live, with the beach not far away and the picturesque downtown vibrant with culture awaiting you every weekend. 

Students at this campus spend half of their time in Savannah and the other half in Brunswick, which is around half an hour away; however, they establish their residency in Savannah and stay in campus housing in the latter. The SE campus has impressive hospitals with dedicated and especially animated faculty, and it seems like it would be a delight (and quite interesting) to work alongside them the next few years. 

I would say the students there were also the most excited and enthusiastic about their campus out of the three.  Curriculum-wise, Savannah (and Albany as well) follows the same framework as Augusta, namely 4-6 week rotation blocks for each specialty and a shelf exam at the end of the rotation. 

The bottom line is, if you are looking for the classic appeals of a regional campus such as the one-on-one attention with the faculty and more hands-on opportunities in surgeries for example, all while enjoying the coastal air, Savannah might be right for you.

Albany (SW):

Albany’s campus seems to be the one to go to if you are looking to get your hands completely filthy in the surgery rotations. Now this was never explicitly stated, but after having heard about all of the campuses, the SW’s spiel was the most convincing about the chances we would have being first-assist right next to the surgeon and delivering babies left and right. For example, the Dean mentioned that we would have the opportunity to “catch” 20 babies by the end of our OBGYN rotation, whereas in Rome they estimated performing somewhere around 5-8 deliveries. This is one of many times I felt that Albany values giving us the best opportunities to learn on our rotations. 

Albany’s hospital also impressed me the most—they boast state-of-the-art technologies housed in a beautiful building with a surprisingly comfortable vibe that I can’t quite explain but I’m sure the patients love. The staff at the hospital also seemed to truly care about the patients and the quality of care given to them, from the clinical standpoint but also from emotional standpoints, which was encouraging to see and hear. And as one of the few major hospitals in the region, Albany takes in every kind of patient from all over the Southwest, providing an excellent learning environment for us burgeoning clinicians. 

Albany as a city is not much to rave about, I’ll admit, but as a whole I believe that the clinical experience will be rich enough of an adventure that a hopping nightlife probably won’t even be missed. And as for recreation, I’ll bet the Dean would love to take you fishing sometime ;)

And there you have it! Now obviously, a lot of my ramblings are based on my opinions and the general feel that I got when visiting each respective campus, so please take from them what you will. I would lastly like to reiterate that, as many people have already mentioned to us, wherever we end up doing our 3rd and 4th year rotations, it will be a remarkable learning experience and most likely all that we have ever wished for. So don’t sweat too much over the next few days about your decision and make sure to celebrate Thanksgiving to the fullest! Happy Holidays!

Lahari Shetty is a second-year medical student in Augusta.  Her interests include OBGYN (at least currently), reading, and a good conversation over coffee/tea!

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Confessions of a Second Year: Beginning Again

First off, I’d like to preface by saying my views may not reflect everyone perfectly, but for the majority I think I’ve hit the nail on the head.

I recall first year days – reminiscing about the green pastures that would inevitably be second year. Boy was I misunderstood! I thought it would be first year plus, but it is indeed a whole new sport I’m playing now. Balancing all the same information and then compounding it with pharmacology, pathology, immunology, and microbiology is something I don’t think I could have been prepared to handle.  But on the positive side- things are really getting interesting. As difficult and detailed as the content may be, we’re really getting an idea of how everything plays out together. I bet most of us have had a few “Eureka!” moments that’d make Einstein roll over in his grave.

Grades- nobody is concerned about grades in the way I thought they might be. Everyone’s battle at this point is his or her own. I’m confident that there are few people that are performing much differently than before, but I’d say the majority is focused on passing the next hurdle. Our concerns reign much higher than quiz points these days. Plus, in the grand scheme, I think many of us have appropriately rationalized that any individual score doesn’t define us. (We’re really deep this year!)

You may have thought field trips were a thing of the past… until M2 year! So many of us have loved visiting our regional campuses in Rome, Albany, and Savannah this semester. Learning more about them keeps our minds set on the next stage in life. In a few months, we’ll be bright eyed and bushy tailed with patients at our disposal. May the life long learning we wrote about in our personal statements serve us well.

Did you think I wouldn’t mention it? Here it is! STEP ONE is certainly the red elephant in the room.  It’s on everybody’s mind. Many of us have already invested a couple months’ rent on resources. Some have literally been studying since day one of medical school. The stress this test brings is constant and varied throughout the population. But no matter the level of worry, we are all cognizant of it. This is not all bad. We need to be knowledgeable and informed about what is coming soon! PATIENTS! I’m so eager for the days that I’ll be trained to help people in need. If it’s just a few tests away- bring it on. I may be young, but I’m ready!

We’re so close to patient interaction we can almost taste it. The next milestone always seems to be the more desired one- and history repeats itself with the Class of 2018. We are taking each challenge head on and eager to reach the new heights we’ve been envisioning for some time now.

May the curve be ever in your favor – and ours!

Nellena Adekoya is a second-year medical student in Augusta.  Her interests include pig collecting, movie watching, and pap smearing.

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Health Happenings: Georgia News Update

There is an abundance of national news headlines regarding the medical field and health policy decisions to catch your attention in recent months. However, there are also important stories happening closer to home regarding patient health and the policies and legislation being implemented to address such concerns. What follows is a brief synopsis of some of the current events happening in the healthcare field right here in Georgia.

1. Maternal Mortality

Several years ago it was reported that Georgia had the highest maternal mortality rate in the country at 28.7 maternal deaths per 100,000 live births in 2011. Maternal mortality is defined as maternal death during pregnancy or within 42 days of the end of the pregnancy. In response, the Georgia General Assembly formed a maternal mortality panel to investigate the matter further and identify areas for improvement. The first report from that investigation has detailed 25 pregnancy-related deaths and 60 pregnancy-associated deaths from 2012 data. Several key elements of the report include: 1) Errors in classification of deaths, suggestion that improved standardization of reporting is needed; 2) African-Americans were represented at a much higher rate in the group; 3) Obesity, chronic medical conditions, and lack of access to care were cited as possible contributing factors in many incidences. The committee will continue to review cases from subsequent years and the Department of Public Health has begun work to improve clinical outcomes and reduce errors in reporting with the data already provided.

2. Cannabis Oil Research

Dr. Yong Park has been leading trials at the Medical College of Georgia regarding the use of cannabis oil in treatment of seizures after approval by the legislature and Governor Nathan Deal late last year. Updated data from the studies will be available in December but preliminary results have shown significant improvement in patients with severe forms of epilepsy, with over 200 families currently qualifying for the medical marijuana registry. The state’s Commission on Medical Cannabis met recently to study the effect of the law and whether it should be expanded to allow growth and distribution of cannabis oil within the state of Georgia. As it stands now, families may be able to possess cannabis oil but the sale of any form of marijuana still remains illegal in the state.

3. Medicaid Expansion

In the June 2012 Supreme Court ruling on the Affordable Care Act, the provision that required states to expand their Medicaid rolls was deemed unconstitutionally coercive by a majority of the court and the expansion became optional for states. The state of Georgia was one of those states that opted out under Governor Nathan Deal. Some lawmakers, however, are working to introduce legislation to expand Medicaid via the General Assembly next year. Georgia remains among the 5 states with the highest number of uninsured in the nation.

If your curiosity has been piqued by some of these topics, I encourage you to keep reading about the statewide stories that may affect medical students and providers.  Applying for and attending the Medical College of Georgia’s Advocacy Day is also a great opportunity to meet with legislators and get a first hand look at how the political process works and how decisions made in the capitol can affect the patients and the medical community throughout the state.

Jaimie Huntly is a fourth year medical student based on the Southeast campus. She is currently applying for residency in Obstetrics and Gynecology. Her interests include health policy, global health, travel, languages, running, and reading.

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Pharmaceutical Price Gouging, The People Behind It, and Why It Needs To Stop

The pharmaceuticals industry has made recent controversial headlines concerning the cost of drugs for patients. The discussion was catalyzed by the actions of CEO Martin Shkreli of Turing Pharmaceuticals, who recently raised the price of Daraprim (pyrimethamine) from $13.50 to $833 per pill after purchasing the marketing rights. Daraprim is an important for treating multiple protozoal agents, including Toxoplasma gondii infections in immunocompromised AIDS patients. This is one instance in a continuing trend of the pharmaceutical industry increasing the prices for drugs that are critical for treating patients who have to either burden the enormous cost or go without the medication they need.

Shkreli faced widespread criticism and backlash to the price increase, and despite public statements that he would lower the price, Daraprim still costs over $800 per pill. This issue is not limited to one person though. There have been many similar instances where companies have dramatically increased the prices of specialty drugs, including the cancer drug Imatinib/Gleevec from Novartis and the anti-parasitic drug albendazole, whose marketing rights were acquired by Amedra Pharmaceuticals in 2010. Furthermore, the pharmaceuticals industry wields significant power that allows these actions to be completely legal. Last year, the industry spent over $250 million dollars and employed over 1400 lobbyists to influence politicians and campaigns. Additionally, many companies spent more money on advertising than research and development, reaping billions in profits per year.

As members of the medical community, our primary objective should be to advocate for the well-being and longevity of patients under our care. While the pharmaceutical industry is crucial towards the development of new and more effective treatments and even cures for diseases, it is, at the end of the day, driven in part by the whims of people like Martin Shkreli and so many other unknown yet powerful corporate entities. Those whims are geared towards profits without regard for life, the bottom line over the impact on families, and most importantly, uninhibited capitalism. Given the power of the pharmaceutical industry and its vice-like grip over so much of medicine, physicians have a responsibility to be the voice for the millions of patients that cannot afford their medications.

Compassion, integrity, and acknowledgement of the significance of human life are the staples of the medical professional, and it is time to bring those concepts to the pharmaceutical industry as well. When the effectiveness of pharmaceuticals are measured by how much profit they can generate over a number years instead of how many years of life it can extend, it is clear that a radical change in the culture of that industry is necessary. Although pharmaceutical companies do not need to become charities overnight, reductions in the cost of medications, reductions in spending on advertisement, increasing spending on R&D and development of cost-effective manufacturing techniques, and limits on spending for political lobbying would be a great first step towards building an industry that works for humanity instead of at the expense of it.

Subhendu De is a 2nd year medical student in Augusta. His interests include medical innovation, healthcare journalism, and current technology. This hobbies include exercising, cooking, and various sci-fi and fantasy media.  

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Hump Day Humor

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Women in Medicine: Thoughts from Two Docs on Laney Walker

Earlier this year, Academic Medicine reported the results of the AAMC’s Women in Medicine and Science Benchmarking Survey.  This Survey was initiated in 1983, and represents a mature and comprehensive data set with over 90% (119) of the 129 medical schools in the U.S. responding.  Together, these AAMC  (American Association of Medical Colleges) data reflect a hopeful, yet slow moving change in the healthcare industry for women across all levels of academic medicine.  The proportion of female faculty new hires rose, but female faculty departures increased as well. The proportion of full-time female professors increased, but only by 7% since 2003, and this increase was offset by an increase in departures from the academe (5%).  More females are applying to medical school, but the number of male applicants also has risen.  Women still represent fewer than 50% of all medical school applicants.

Although these AAMC data do not promote much optimism, female health care professionals in the beginning, middle and end of their careers must continue striving for a seat at the table.  Consider these 4 tips from two senior MCG faculty members who served as faculty participants during this forum:

1. It’s Vital to Know Your Mission and Purpose

Reflect on your life story and identify your passions.  The way you deal with early challenges in your life often defines you.  So ask yourself:  What is my life story?  What parts of this story have shaped the person I am today – have resulted in the values I treasure?  What am I truly passionate about?

It is likely that your passions, if authentic, will intensify and converge into a short ‘list’ over the years.  This narrowing can serve as a compass on your career path, helping you to define your priorities – both personal and professional.

2. Take Charge of Your Career

You are in charge of and responsible for your own career.  If you decide to sit idle and let your career “happen” the outcome is uncertain.  However, if you take the reins and guide your journey mindful of your purpose, with your specific goals in sight, and also remain open to support from others; you will determine your own destiny and legacy.

• What are my near term career goals?
• Who provides support for me in my network as I strive to achieve these goals?
• Who are my mentors?
• Who are my advocates/sponsors/champions?

3. Know your Priorities – both Personal and Professional.  What are your boundaries at home and work and always operate within them. 

4. Learn How to Negotiate.  When it comes to negotiation, confidence is not masculine or feminine.  It’s a practice.

As Steven Covey has advised us:   “Begin with the end in mind.”  And of course, enjoy the journey, too!

Honoring the light in you all -

Nita & Caryl

This is a guest post from Drs. Maihle and Hess.  Thank you for sharing your great wisdom with us!

Dr. Nita Maihle is a cancer biologist who was recruited to GRU in 2013 to develop educational programming for the GRU Cancer Center. She also runs a research laboratory where she studies breast, ovarian and other women’s cancers, with a focus on biologically targeted therapies and biomarkers for early detection. She was on faculty at the Mayo Clinic for 15 years, and Yale University for over a decade. During her career she has served in numerous leadership capacities, including service on the Board of Scientific Counselors for the National Cancer Institute, as well as President of Women in Cancer Research, a ~7,000 member Council of the American Association for Cancer Research.

Dr. Caryl Hess joined GRU in 2014 as  the Director of the Office of Leadership Development.  She oversees the GRU Leadership Academy, a program which promotes the development of leadership skills and abilities.  She is the former director of the Cleveland Clinic Academy where she oversaw the leadership and management curriculum and courses for 43,000 physicians, nurses, and administrators and directed various external, revenue-generating programs, including the Samson Global Leadership Academy, Cleveland Clinic's global leadership program for healthcare executives.  She has conducted research, presented and spoken to diverse audiences on the topics of leadership development, curriculum and technology.  

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