AAMC-OSR

Annual Digest
November 27 2012 San Francisco

by Rob Guglielmo Laura Muscianese Emanuele Maccalli Colleen Kays Laura Douglass Leland Husband

Special thanks: Ally Anderson Monique Mauge Shannon Boone Attribution: Meeting photos courtesy of Samuel Carmichael, OSR Kentucky. More information, including contact information, about the Student Programming Showcases can be found on the OSR Medical Education Resources website or the program descriptions.

Contents

Letter from the Chair Social Media in the Healthcare Setting E-Folio Update Diversity Drives Institutional Excellence Arnold P. Gold Foundation Humanism in Medicine Award Learner Mistreatment The Skys the Limit NBME Update Preparing for Your Future Career OSR 101/201 Humanism in Medicine NRMP/ERAS Update LGBT Education: Adequate Preparation? Innovation Arc: New Visions

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Letter from the Chair

Dear OSR, On behalf of the OSR Ad Board, thank you for helping to make the 2012 AAMC-OSR Annual Meeting such an excellent event and for all of your contributions to academic medicine. Your efforts at your local institutions, regional meetings, and national meetings help create lasting changes. The lively discussions help us exchange ideas, engage in meaningful dialogue, and form meaningful relationships. As youve no doubt noticed, the digest has a new design. It is one of many the many projects we plan for this year. Each committee works hard to identify projects that will benefit medical students now and in the future, but we need your help. Reach out to us with your ideas. Let us know what we can do for you. The following pages summarize key sessions from the 2012 Annual Meeting. As you read through these pages, let ideas develop and take them to your deans. Were all looking forward to hearing about your ideas at the regional meetings. Respectfully, Ronnie Zeidan AAMC-OSR National Chair Medical College of Georgia at Georgia Regents University

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Social Media in the Healthcare Setting

by Laura Douglass and Leland Husband, Southern Region

Did you know there are 24 billion people online? Or that social networks account for one in five minutes online? In 2010, social networks knocked porn down to become the reigning king of the internet. Healthcare, like other industries, must embrace social media. Mayo already took the step by hiring Dr. Farris Timimi as the Medical Director for the Mayo Clinic Center for Social Media. Dr. Timimi explained how social media facilitates social constructivism. People all around the world can team-up to complete a project without the constraints of space and time. It sounds very scifi, but its just the internet. Kind of neat. UndergroundMedDartmouth and NYU
Students from Geisel School of Medicine at Dartmouth and New York University School of Medicine saw a problem with medical education. Students learned medicine, but they needed to learn culture too. The solution: create medical videos by students for students. UndergroundMed contains more than 50 videos packed with timely information culled from past and current students. Each high-yield video provides clinical rotation pearls. Check them out on the web at http://videos.undergroundmed.net/.

Four cases, presented by Dr. Timimi, highlighted potential uses of social media in healthcare. Case One showed that the public wants podcasts and blog posts from physicians. Case Two told the story of Jayson Werth. Jayson, a

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baseball player, injured his wrist when it took a bad pitch. When the pain didnt go away, he sought help at Mayo. The diagnosis was difficult. Mayo filmed Jaysons story in his own words and posted on the internet. The story exploded through social media, leading to a patient with five years of similar pain reading a tweet of Jaysons story. The patient shared the same injury as Jayson. If it werent for Twitter, the patient wouldve continued without a diagnosis. Case Three pointed out that social media can expand research participants and let patients drive research. Katie and Laura, patients, read about a womens heart conference at Mayo. They approached the researchers about spontaneous coronary artery dissection (SCAD), a rare, little studied condition. The result, a SCAD clinic comprised of OBGYN, genetics, and interventional radiology. They were able to find 200 patients from across the world to join a study. Case Four highlighted a young girl with a mysterious

diagnosis. She visited over 50 doctors, but a diagnosis for her nausea, vomiting, and diarrhea remained elusive until someone saw a video of the patient four years later. She was diagnosed with postural orthostatic tachycardia syndrome (POTS). In tow with its merits, social media introduces perils in healthcare. Healthcare workers may violate privacy. Patients trust people who may falsify credentials online. These valid concerns should be addressed. Institutions should construct policies and goals to guide employees in social media. Physicians need to leverage these tools to offer more personal patient care. Bryan Vartabedian, Baylor, would ask what Osler thinks. Would Osler embrace social media? Mr. Vartabedian thinks so. He thinks Osler wouldve embraced technology that improved patient care, technology that let patients drive change, and technology that narrowed the gap between patient and doctor. If Osler would embrace social

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media, he wouldnt go all willy nilly about it. He would urge that we maintain professionalism. In this time, he would protect the patient. Protecting the patient means privacy and cultural shifts. Schools need to help medical students explore social media. Physicians need to combat the misinformation with helpful information. There are many avenues to use social media to help us become better students and physicians, but whatever direction we choose, we must always ask what is best for the patient? E-Folio Update by Robert Guglielmo, Central Region Medical students and residents need tools to make life easier. We need to grab the reigns of our educational destiny. EFolio will help. The E-Folio, formerly eFolio Connector (eFC), offers students and residents tools to aid credentialing and job search. Tools that let you decide who sees what. For example: Maintain biographical information like education,

research, work history, and immunizations Add MCAT or USMLE scores or certifications Keep ACGME case logs and license history Export to USMLE or ERAS applications Create a new curriculum vitae The pilot starts March 2013 with full release the following summer. Expect subscriptionbased pricing under $100 for students and $125 for residents. AAMC wants help perfecting E-Folio. Contact me at [email protected] for details.

HealthcareReformForumUTHSCSA
Three years ago, students from the UTHSCSA, University of Texas Health Science Center at San Antonio, started the Healthcare Reform Forum elective to give students a non-biased discussion to learn about changes in healthcare. Students love it. The elective consists of five evening sessions covering topics chosen by students. Each topic includes a reading, guest speaker, and two student moderators. Faculty takes a backseat. Course scope will by including more students and non-physician speakers.

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Diversity Drives Institutional Excellence

by Laura Muscianese, Western Region

According to Norma Poll-Hunter, PhD., children begin shaping their career profile by age five. This assertion fueled Dr. Poll-Hunters development of pipeline programs at Albert Einstein College of Medicine. These programs would expose K-12 students to medical career opportunities. These programs help make career goals a reality for students who meet undergraduate or postbaccalaureate standards. Albert Einstein College of Medicines Summer Medical and Dental Education Program (SMDEP) was showcased, S4GIFTNYU
NYU students created S4GIFT, Students for Growing Interest for Transplantation, because they wanted more transplant topics in their curriculum. S4GIFT spread to 23 healthcare schools around New York, helping recruit nearly 700 new donors.

but similar programs are available at other institutions. SMDEP: SMDEP is a six-week, nationwide program for college freshmen and sophomores in science tutoring, clinical exposure, and career and financial planning seminars. The program prepares under-represented minorities to apply to medical and dental school. Under-represented minorities includes more than race and ethnicity; it also includes economically or educationally disadvantaged students and those interested in serving under-served populations. Bronx Science and Health Opportunities Partnerships

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(BxSHOP): BxSHOP collaborates with institutions to provide students a longitudinal program from middle school to post-baccalaureate. The program includes the Einstein Enrichment Program, which offers under-served high school sophomores and seniors with year-round academic tutoring, service projects, and medical shadowing. The BxSHOP high school component achieved a 100% high school graduation rate and a 100% college commencement rate. University of Buffalo (UB) Post-Baccalaureate Program: The UB post-baccalaureate program collaborates with nine different New York public medical schools to offer under-represented minority students conditional acceptance when they meet certain standards. Albert Einstein College of Medicine under-represented minorities remain under-represented despite the pipeline program success. Future healthcare diversity depends on these pipeline programs. Unfortunately, funding depends on private donors and grants. This dependency indicates people dont understand how important pipeline programs are to under-represented minorities. As Dr. Norma Poll-Hunter remarked, We must not only encourage our institutions to value diversity, we must demonstrate the need to harness diversity through an overall change in our behavior.

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Arnold P. Gold Foundation Humanism in Medicine Award

by Robert Guglielmo, Central Region

Have an amazing faculty physician at your school? Honor them by nominating her for the Arnold P. Gold Foundation Humanism in Medicine Award. Each year, OSR selects a physician who exemplifies the qualities of caring and compassionate mentor in the
Dr. Chin-To Fong, 2012 Arnold P. Gold Foundation Humanism in Medicine Award recipient. Image from University of Rochester.

teaching and advising of medical students. The physician must teach ethics, empathy, and service by doing. Physicians like this years recipient Dr. Chin-To Fong. Dr. Fong would insist the honor is treating patients. Though we agree, we couldnt help enjoy his touching patient stories as we celebrated his honor. Visit https://www.aamc.org/members/osr/humanism/ to find out about the 2013 nominations.

Learner Mistreatment
by Laura Muscianese, Western Region

The 2012 AAMC graduation questionnaire data reported that 47% of students experienced learner mistreatment (e.g., public humiliation, physical harm or threatened physical harm, sexist remarks, discrimination against sexual orientation) during their medical education.

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Institutions combat learner mistreatment, a nation-wide problem, with policies that emphasize professionalism over status and mechanisms to fairly address learner mistreatment cases. Gerald Hickson M.D., Vanderbilt University School of Medicine, presented a way to deal with learner mistreatment. His pyramid model emphasizes 90-second physicianadministrator interactions, selfadjustment, and institutional intervention when needed. HELPNYU

Health literacy plagues every practice. NYU students started HELP, the Health Education Literacy Project, to improve health education and literacy. HELP uses Harlem residents that medical forms and literature confused. The six lesson plans, coupled with group activities to encourage discussion, cover hypertension, diabetes, and nutrition. HELP finds that more education means better health quiz scores. Future lesson plans will cover weight and diabetes risk.

The Skys the Limit

by Emanuelle Macalli, Northern Region

The session subtitle could have been mentorship, leadership and innovation because thats what we saw. Ronnie Zeidan, OSR, moderated talks by Drs.

Yvonne Cagle, NASA, and Paul Pasquinade, Army. Dr. Cagle began by discussing the challenges space medicine faces, challenges like space adaptation syndromea brain fog caused by plasma redistribution that astronauts experience in the first 72 hours in space. She described how people on the ground use space technology like NASAs Star Trek Tricorder. Deployed Tricorders, a miniature diagnostic tool with built-in tutorial, wirelessly link to providers at a home
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base. She concluded by reminding the audience that healthcare requires patient mentorship. Dr. Pasquina discussed the Armys healthcare changes since September 11th. The Army tries to improve care for soldiers at all levels. Care begins on the battlefield and continues to psychiatric support for soldiers at home. The military uses innovative tools to improve outcomes like robotic prosthesis. Soldiers lose limbs. Improve field

HandsOnEthicsMiami
Looking to start a hit program at your school? Try what University of Miami Miller School of Medicine students did. LCME requires ethics discussions before third year. The students wanted more than small-group case discussions. They solicited hospital ethics committees to reserve spots for student observers. The students volunteer. Attendees learn, first-hand, to handle complicated medical situations from professionals.

care means more soldiers return home as amputees. Robotic prostheses offer these soldiers use of a lost arm or leg. The electrical impulses from the soldiers brain powers the prostheses. Dean Kamen gave a Ted talk on these prostheses too (http:// www.youtube.com/watch? v=RiJzJ771vDw).

Ronnie Zeidan closed the presentation with a student prospective. Technology, he warned, can be dangerous. It can remove human contact, breaking the necessary bond between patient and physician.

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NBME Update
by Emanuelle Macalli, Northern Region

1.Fostering a relationship with

the patient 2.Behaviors supporting the patients emotions 3.Gathering information 4.Providing information 5.Making decisions 6.Enabling patient behavior (under development) Step 2CK will also change the post encounter report. The original report required a complete history and physical with five differential diagnoses. The new report requires three differential diagnoses with positives and negatives for each. Step 3 will be split into two exams that dont require consecutive test days. It will also contain Step 1-type questions. For more information, visit the NBME website at http:// www.nbme.org.

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Drs. Butler and Katsufrakis discussed USMLE Step-based subject exams, student question banks, exam changes, and security. The highlighted USMLE Step-based subject exams features include: Performance profile for each examinee Compare results to potential Step scores Available at Prometric centers (Schedule for availability) Custom exams built by your schools faculty Students should expect new question banks from NBME. These banks will you help prepare for Step 1, 2CK, and 3. Like the subject exams, the question banks will give the student a performance profile. The NBME website has more information on the subject exams and future question banks. Step 2CK will replace the checklist score with the six skills below:

Preparing for Your Future Career

by Laura Douglass and Leland Husband, Southern Region

Career choice requires decision. Decisions about what you want from medical school,

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what you want from residency, what you want from your career, and ultimately your life. Drs. Mark Wilson, Iowa; Patricia Barrier, Mayo; and Scott Lind, Drexel, think they can help us make better career decisions. All three shared common insights. Students should find a place where they fit in. But finding that fit can be difficult. Dr. Barriers four Ps might help you break the indecision barrier: 1.PeopleDo you like people? Do you fit in? Do you feel comfortable? 2.PatientsWhat patients do you want? Who do you want to spend your day with? 3.PeriodicalsWhat conferences do you want to attend? Whats your favorite journal? 4.PajamasWhat rotation made you want to get out of the bed and see patients? Dr. Barrier encouraged students to ignore the chattering monkeys that question your decisions and know what you should do; while Dr. Wilson encouraged

students to avoid programs with symptoms of struggling residents: Poor basic task skills and work ethic Only focus on task or getting through shift Stuck in reporter mode Arrogant and rude Dont know what they dont know Drs. Wilson and Lind both recommended being a bright, hard-working student that displayed professionalism while maintaining academic excellence and humility. Dr. Lind also recommended finding a career mentor. Whatever you do, we hope you enjoy doing it.

OSR 101/201

by Colleen Kays, Northern Region

OSR 101 and 201 provided a welcoming atmosphere for new and returning OSR reps at the 2012 AAMC Annual Meeting in San Francisco. OSR 101, led by OSR Chair-Elect Ronnie Zeiden and Northeast Regional Chair Judy Wilber, offered new OSR reps a chance to better

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understand AAMC and the OSR. New reps learned about their roles as OSR in school and AAMC. Returning OSR reps attended OSR 201, facilitated by OSR Chair Joe Thomas, OSR Immediate Past Chair Dave Friedlander, and Southern Regional Chair Anne Porter. Returning reps caught up with friendly faces and discussed the best ways to maintain an active role as an OSR rep.

from the novel The English Patient, Participants described patient rooms from the perspective of someone in the room.

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NRMP/ERAS Update

by Colleen Kays, Northern Region

Humanism in Medicine
by Emanuelle Macalli, Northern Region

Blake Charlton found escape from a rare form of Dyslexia in science fiction. His escape became a profession. The medical student authored the fantasy novel Spellwright. The young wizard of Charltons novel also has dyslexia. Mangled spells marginalize the young wizard, but they dont keep him from a greater destiny. Charlton encouraged participants to dream of greater destines. He cemented the dreams with three writing exercises. Following excerpts

The annual OSR NRMP/ ERAS Update included current Main Residency Match trends, Supplemental Offer Acceptance Programs (SOAP) first-year evaluation, All In Policys upcoming implementation, and future changes to the Electronic Residency Application Service (ERAS). The presentations, given by Mona Signer, Executive Director of the National Residency Match Program (NRMP), and by Amy Mathis-Bodor, Manager for ERAS Medical Student and Applicant Relations, can be found on the AAMC website. Ms. Signer highlighted unmatched applicant and unfilled residency-training position characteristics. Recently, Main Residency Match positions, unfilled positions, and unmatched

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applicants increased. In 2012, preliminary positions accounted for half of the 1,246 unfilled Main Residency Match positions. 0.25 SOAP aims to fill the unfilled positions. The following summarizes 2012s results: 13,000 eligible applicants 1,800 US allopathic senior medical students ~1,100 available positions ~550 preliminary surgery positions ~100 preliminary internal and family medicine positions 98 positions remained after SOAP Orthopedic surgery, general surgery, and emergency medicine account for most unmatched US allopathic senior medical students. NRMP and ERAS anticipate further changes to the 2013-2014 application cycle. ERAS, updated based on feedback from applicants, will soon include two-way messaging through the Message Center and other

updates. NRMP will implement the All In Policy, requiring all programs participating in the Main Residency Match to submit all positions. The All In Policy will end the current practice of offering independent applicants a residency training position outside of the Match, an option that is not available to US allopathic senior medical students. The policy will also increase the total number of available positions and applicants. Further information about the NRMP, including program match results and match tips for applicants, can be found at http:// www.nrmp.org. ERAS information can be found online at https:// www.aamc.org/students/ medstudents/eras/.

LGBT Education: Adequate Preparation?

by Leland Husband, Southern Region

Anne Porter and Judith Wilber moderated a very informative session by William White. Mr. White, a Stanford medical student and

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LGBT Medical Education Research Group investigator, discussed the importance of LGBT education in didactics and patient care. Most medical education lacks formal training in LGBT specific needs. LGBT is a unique population with varying medical needs. As such, they warrant consideration from medical school curricula. Ignoring LGBT health needs and education will lead to poorer outcomes. Further, health education should ameliorate discrimination based on a lack of education. Simple actions can make a world of difference. For instance, I learned that when dealing with a transgendered person, I should introduce myself as Im Mr. Husband, and I prefer male pronouns. Many students initiate LGBT clubs or other extracurricular activities to supplement the standard medical education. Instead, we may need to look for ways to make LGBT education a staple of our education. Youre encouraged to contact Mr. White for more information.

LGBT Education: Adequate Preparation?

by Leland Husband, Southern Region

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Dr. Eric J. Topol, cardiologist, hasnt used a stethoscope in two years. He still sees patients. If he had it his way, no physician would use a stethoscope, but every physician would do a bedside echocardiogram and ECG. He uses a pocket ultrasound device for a bedside echocardiogram or his iPhone for bedside ECG (AliveCor). Technology is here. We live in the age of big data and social media. An age where a doctor can give patients immediate feedback and share electronic resources. An age that hopefully beckons revolutionary changes in how we deliver healthcare. Dr. Topols book, The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care, offers insight into the ways technology can change our practice. If were smart, well let technology tear down our practice. Then well rebuild our practice...bigger, faster, stronger.

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2012 AAMC-OSR Annual Digest