Tag Archive | "medical school"

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#RealTalk: Cultural Facts & Perspectives that will make you a better doctor-

Posted on 21 August 2016 by Tammy Wong (Meds 2018)

The #RealTalk series allows our fellow students to share their ideas about how healthcare intertwines with their cultural and/or religious background. Check out this interview with 2nd year medical student Tammy Wong:

What is your background?

I was born and raised in Canada by Chinese immigrants from Hong Kong. My parents are Buddhist and raised me with traditional Chinese values.

What aspects of your culture differ from the stereotypical norms?

Family values: Chinese families focus largely on respecting and caring for elders and often decisions are made as a family, especially in relation to healthcare plans for patients. Furthermore, it may be hard to elicit patient wishes from the family’s wishes if they differ, but if physicians were perceived to ‘go behind/around’ the family then it would cause distrust in the system.

Food: One tradition when family members are in hospital or are ill, is that families will bring lots of cultural food to the patient so physicians should keep this in mind if there are diet restrictions for inpatients (i.e. NPO, low salt, etc).

Perspective on death and dying: Many Chinese immigrants, especially elders, are very superstitious. There is an idea that you will jinx something by saying it aloud so often patients avoid talking about death or risks with procedures. As a physician, you need to talk about these so you have to elicit it somehow from the patient. There is also a feeling of duty from remaining family members that they need to do everything that they can to ensure the patient’s survival, so a discussion about palliative care may be harder to approach but is necessary, especially if it coincides with patient wishes.

Perspective on mental health: There is usually a stigma regarding mental health among Chinese families. Many Chinese people do not really believe in the concept and think that you should just ‘get over it’. They also worry about being labelled with a mental health condition and often refuse to address it. This is something that physicians should be aware about and should try to educate to reduce the stigma.

Language barriers: Like with many other cultures, there may be a language barrier when speaking with Chinese patients. Furthermore, in Chinese culture it is common to nod or make sounds of agreement as a symbol to show that the listener is paying attention and as a form of respect. However, in contrast with Western culture, ‘nodding’ doesn’t always mean understanding and agreement; it is just to show respect and listening. Ask if they need clarification and summarize to check if patients actually are understanding.

Paternalistic view of medicine: Particularly with the elderly Chinese patients, they may be used to doctors telling them what to do and not really asking questions about their wishes or opinions because this was the format they were brought up with. Patients are also taught that doctors deserve respect and should know what is best for you. It is important to ask for patients’ wishes and values and to explain risks to help them make informed decisions, rather than just having them follow what you recommend.

Tell us a bit about Traditional Chinese Medicine

Traditional Chinese Medicine (TCM) is still largely used by the Chinese community under the view that it can treat the body holistically and strengthen the body. Often patients will use TCM while also being treated with Western medications. In some cases, private insurance companies may require prescriptions for acupuncture, etc in order for the treatments to be covered. Without the prescription, the treatment can be very expensive and patients may need to go to ‘sketchier’ or unlicensed providers to save money which is more dangerous. Consider prescribing these treatments even if you don’t really believe in it to help out a patient pay for this, especially for a chronic disease that may not be curable with Western Medicine.

When performing a physical exam, what should be done that differs from what we are taught at school?

While there isn’t anything specific to ask about, many Chinese citizens are very modest so proper draping is very important, especially with elders. Ask if the patient would like anyone else in the room (i.e. spouse or family members) and explain what you are doing very clearly.

If you could give one piece of advice to us future doctors on providing care for your population, what would it be?

Always ask for clarification/understanding and take a bit of time to ask if there are any other issues when speaking with Chinese patients. They may not discuss their true fears or opinions until later on in the interview, especially if it is something embarrassing, sensitive or worrying to discuss. Mental health issues also fall into this category because it is often brushed under the rug. Be sure to ask and also suggest lots of supportive resources for these patients.

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The Other Side

Posted on 07 April 2014 by Jimmy Yan (Meds 2015)

Last weekend I got a chance to be an interviewer for the Schulich School of Medicine & Dentistry admission’s weekend. I didn’t originally expect to be a part of the panel, it was going to on a post-call day while on a busy General Surgery service and earlier in the month received an email stating that all the spots were filled and I would not be needed.

Fortunately, someone could not make it last minute and I was given the opportunity. Post-call or not, I was going to take it.

While this was not my first experience interviewing others for important roles nor was this the first time I was helping out with the Schulich Medicine Admissions weekend. This was, however, this was the first time my role would be part of the interviewing panel. The weight of having my opinion, experience, and judgement be made into part of the consideration of what gets a medical school hopeful accepted or not does not escape. It’s a tremendous honour and I was initially a little nervous about being suitable to fill such a role.

Then I did a gut check and realized whatever anxieties I may be having are dwarfed by what a good chunk of the interviewees must be feeling. #Firstworldproblems? More like #MedStudentProblems.

So what can I say about the experience of being on the other side? Well, first of all, not much in terms of details. That contract of confidentiality we all sign at the beginning of the day was fairly clear on that. So, sorry hopeful premeds (who I doubt are reading this anyway), no hints here.

The experience did let me to think back and try to remember what it was like to be one of the interviewees again. That whole memory was only 3 years ago, but it seems so distant in the past. Yet, that time seemed to past so quickly as well. Very strange how alien the memories of pre-med school Jimmy feel to current med school Jimmy.

There was a deja vu sensation in how tired I was that morning, coming off post call following a whole night in the OR (10:30pm – 7am of operating, I’m not joking) will do that to you. I didn’t sleep the night before my Schulich interview either, as I was spending it on a turbulent red-eye flight from Vancouver to London. It was also a little fitting that I was still stuffing my “dress-up” clothes – a suit and tie back in 2011, business casual slacks and a button-down in 2014 – in beat up trekking backpacks. Wrinkles be damned.

However, prior to my medical school interview, I had never been to either Western or London and I remember being incredibly confused on figuring out how to get from York street to the Western Campus. The sense of being lost and almost late to an interview doesn’t help one’s nerves, and I could imagine that for a lot of last weekend interviewees that they, too, would be leaving their home schools, home towns, home provinces for this one day. In 2014, I have a much better sense of London, and even a tiny bit of the surrounding region. At least I could easily find the stupid purple balloons at the entrance this time.

Surprisingly, thinking back, I was a lot more self-assured prior to entering medical school. I knew the undergrad system that I was in at UBC, I knew how to excel in that setting. These days, not much at all. I’m constantly feeling lost in medical school. Information I thought I had studied just the night before, suddenly can’t recall it when I’m being pimped. There’s always something new to learn and yesterday’s achievement is today’s square one. Looking and listening to these fresh, well rested, faces, I know a bunch of them deep down think they are the shit. Without a doubt they are incredibly decorated and accomplished people. I wonder if they really realize what’s lying ahead for them (Somedays the only solace I can take is that hundreds of other students have gone through the same experiences as I have, faced the same challenges, and emerged out of it MDs). As an old rugby coach used to say, “Trust the system.”

One last stark difference is this time I’m in the know. As an interviewee, it was hard not to try to read in between the lines and try to figure out what exactly the question used was getting out. Turns out there definitely is a method to the madness. As an interviewer, it’s quite clear how we were supposed to be directed in our panels. That’s the most I can divulge I believe, due to the aforementioned confidentiality clause.

One final thing I should mention is that as both an interviewer and interviewee I had a great time. Being new to Western in 2011 I was blown away by the hospitality, enthusiasm, friendliness, and community spirit shown by the admissions volunteers. That impression definitely was a driving force in my decision to choose London in the end. On the other side of the panel, I had a great time connecting with the other panelists on my team. There were also breaks to get to catch up with some classmates and other volunteers. There are definitely a fair share of good feelings behind the scenes as well.

With the past weekend over, that wraps up the 2014 Admissions Weekend for Schulich. It’ll be a nervous and exciting time for the interviewees I’m sure. I am curious to see if the people who went through my panel got accepted and end up choosing Schulich for next year. If one of the them do end up coming to school here, I do hope that at some point within their 4 years they get to have a chance to side on the other side too.

So the cycle continues.

 

 

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Learning and Grades

Posted on 18 July 2012 by Anurag Bhalla (Meds 2014)

An academic institution is regarded as a place where an individual obtains knowledge to be an informed and contributing member of the society. Medical school is one of these places where students gain medical knowledge and skills necessary to be a competent clinician. Whether a person has been successful in attaining a set standard of proficiency is often measured by a standardized examination. The more time I spend in educational institutions, the more I come to realize the inherent flaw in such an objective measurement of performance. Continue Reading

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A letter to incoming medical students

Posted on 18 July 2012 by Sarah O’Connor (Meds 2014)

As my classmates and I eagerly await the results of our clerkship lotteries, I can’t help but think back to the beginning of medical school two Septembers ago. I was so eager to embark on this terrifying and exhilarating journey, convinced the years ahead would be the best time of my life.

At the risk of sounding jaded, there are a few things I’ve learned in the last two years that I would love to pass along to you. Things I wish someone had mentioned to me when I was in your shoes, having just been cloaked in that prestigious white coat, thinking fondly to the years ahead. Continue Reading

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