FastWave Medical’s Post

Just came across this important study in The Journal of Clinical Investigation Insight by Darnell K. Adrian Williams Jr., Briana Christophers, and Myles Akabas, among many others involved in MSTP education at Albert Einstein College of Medicine, Weill Cornell Graduate School of Medical Sciences and many others. This study serves as an important reminder that structurally entrenched biases significantly impact admissions and access to education and training program opportunities, no matter how objective we'd like to think we are as individuals. Racial, socioeconomic, and other diversity in our scientific and medical community is critical to our path to progress in science and medicine. It's important that we take a moment to acknowledge the evidence that we're not where we should be yet. Congrats to all the authors on this important study. From the abstract: "Our analysis of data from the Association of American Medical Colleges covering 2014–2021 (15,156 applicants and 6,840 acceptees) revealed that acceptance into US MD-PhD programs correlates with research experience, family income, and research publications..... Applicants were less likely to be accepted if they had parents without a graduate degree, were Black/African American, were first-generation college students, or were reapplicants, irrespective of the number of research experiences, publications, or presentations. These findings underscore an admissions bias that favors candidates from affluent and highly educated families, while disadvantaging underrepresented minorities."

The US News lists new skills that premed students must possess. As the landscape of medicine evolves, premed students must acquire a diverse set of skills beyond traditional scientific knowledge. According to relatively recent updates from the Association of American Medical Colleges (AAMC), key competencies now include socio-cultural awareness, collaboration within healthcare teams, and early clinical exposure. Additionally, self-care practices, such as regular exercise and stress management techniques, are crucial to prevent burnout and maintain a balanced lifestyle Developing these skills will not only prepare future young physicians for medical school but also enhance their ability to provide holistic patient care.

What is an academic physician? I always thought it was someone that sees patients, teaches trainees and conducts research under the umbrella of a university/teaching hospital/medical center. But, with consolidation this leads to interesting changes in definition. The paragraph below provides one interpretation (an article from one of American Society for Radiation Oncology journals, linked below). If you work for a satellite, you get a title. Even if you never teach residents or publish papers, you're academic. If you're on the webpage as faculty, you're academic, no matter what you actually do. Why does this matter - how we are categorized? Well, for one, academic radiation oncologists typically are compensated less. It does not matter if you do less, same or more than a community doc - in general you'll earn less. An example of this is when an academic practice buys out an existing private practice. They call it an academic satellite, they employ "faculty", they slash the salary to equalize with main. But, other than the layers of bureaucracy, the 8 bosses and the endless committees, for the radonc it is the same job for less money. I say this b/c I speak to dozens of academic physicians. They work really hard. Many (most?) see more patients than I do. And they teach students/residents. And they write papers. Occasionally, some of those paper are even good! And, they make very little. I'm not sure why 9000 RVUs under the banner of a university is of less value than my 9000 RVUs. This is under professional fees and it would make sense to pay the producers of said RVUs. Then there are the satellite physicians, who see many patients - like a non-academic physician - but because they are on the faculty website now, they get an attenuated salary in comparison to if it had stayed a community center. Where does this money go? Is this fair to those that do the same amount of work as community physicians who are paid a higher rate? If we are having academic docs reach clinical targets that equal or surpass their community counterparts, do they really have time to engage meaningfully with trainees or publish something that matters? Are they truly academic doctors? Or are they just clinicians having their salary skimmed from the institution? There are much more qualitative/descriptive/demographic work, surveys, non-cancer patient related research (carbon emissions from linacs, number of X identity in leadership positions). This work is important, but it is very different than designing a study or innovation with data analysis. Resident after resident will tell you about the rotations they barely learned a thing, b/c the attending was so busy. I was once on a rotation where the attending was gone for at least 6 of the 12 weeks. Many patients never once saw the attending physician. I think we really need to re-evaluate what an academic physician is and how they are compensated. https://lnkd.in/g6cswTWB

🏥 This Week in Med School 📚 It's been an exciting, insightful, and demanding start to the core Medicine clerkship over at the Johns Hopkins Bayview Medical Center! Here are three learnings and reflections (out of 100s) this week: (1) *Incredible Team.* Two reasons that trainees often find the Medicine clerkship to be the most challenging one are (a) the sheer volume of information required to appropriately manage the care of our sickest patients (from heart failure to anemia to cancer), and (b) the active responsibilities that students take on including helping admit patients and writing H&P and Progress notes. Fortunately, I've worked with two incredible teams already and have been impressed with how much the interns, residents, and attendings (1) care for their patients, (2) know and do efficiently, and (3) enjoy actively teaching students. There was a nice "Osmosis in the Wild" moment when a physician was doing a case report and popped up an Osmosis.org from Elsevier infographic on the coagulation cascade (one of the most complicated pathways we have to learn about to understand bleeding disorders). (2) *Decision-making capacity.* We've already had to assess decision-making capacity on several patients due to altered mental status (e.g. hypercalcemia, dementia, etc). A nice mnemonic published on Science Direct in the Elsevier journal CHEST (cc Laura Hassink - ter Haar, Carl Schwarz, Judith Escales) is CURVES: choose/communicate, understand, reason, value | emergency, surrogate (link in the comments). (3) *Call for companies turning clinical documentation into insight.* I've featured several innovative generative AI companies on the Osmosis #RaiseTheLine podcast over the past few years (e.g. Abridge / Shivdev Rao, Suki / Punit Singh Soni) which are helping reduce the burden of documentation on providers through ambient audio --> SOAP note workflows. I'd love to hear about more companies and individuals who are actively transforming these non-standard and often poor quality notes into more visually appealing and sensible summaries (e.g. visual timelines, enhanced search results that answer questions) so we can feature them on the podcast and help them scale. More commentary about this in the video below. As always thanks for listening and engaging, and wishing you all a happy start to Q2!

Research & Residency Match: Insights from UND Medical Students The UND School of Medicine & Health Sciences Medical Research Student Interest Group met to talk about how research experiences factor into residency applications. We heard from four 4th years who recently matched into highly competitive residencies. They shared their experiences and insights, along with a discussion based on the research by Wolfson et al. (doi: 10.1097/ACM.0000000000005256). Here are some key takeaways for #medicalstudents considering research: - Boost your competitiveness: Research is especially valuable for applicants aiming for the most competitive residencies. - Be prepared to discuss your research: Residency interviews often ask about your research experiences. Be ready to talk about your project's significance or at least your research exposure. This is also a great opportunity to showcase valuable skills sought by program directors. - Every accomplishment counts: Don't underestimate the value of your research products. Published papers are fantastic, but poster presentations and even submitted manuscripts showcase your dedication and effort. - Start early! Research takes time: Beginning research early in medical school allows you to participate in multiple projects and have ample time for publication and presentations. - Align your interests, explore broadly: Align your research with your career goals, even if the type of research is outside of the area you hope to match in. A diverse research background can be a major asset! #UNDproud #medicalresearch #researchexperiences #medicalstudents #medicalschool

Quite a worrying trend that can impact #research quality & eventually harm clinical decision making. "Yet an analysis of PubMed-indexed publications found that most medical student articles were reviews or case reports, and the majority (59%) were cited not even once. Rather than scientific curiosity, the burgeoning research output by medical students is partially a consequence of the residency selection process." https://lnkd.in/eY5RFFAC No wonder there's a rise in paper mills and groups exploiting #IMGs. We covered this recently - https://lnkd.in/eDBNV9gs

The Weizmann Institute of Science, in a joint initiative with the Miriam and Aaron Gutwirth Fund, is set to establish a medical school, through which it will launch a unique program to train the next generation of physician-scientists. This uniquely specialized program accepts 40 outstanding and curious students looking to make a difference and advance their professional careers by taking part in Weizmann’s scientific research activity and will undergo clinical training at medical centers across Israel. Prof. Alon Chen, President of the Weizmann Institute of Science shares, "The new program will help physicians of the future apply the most contemporary and innovative scientific knowledge in the field of biomedicine." Registration is expected to open at the end of 2024. For more information about the MD-PhD program read below. #medicalschool #biomedicalresearch #personalizedmedicine #future #physicianscientists #futuremedicine

Proud to share that last week uniMIND Prague was invited to give an introductory seminar about #PsychedelicScience at the #UIMS (United International Medical Schools) medical student conference #DoT 'Doctors of Tomorrow'. William Lytle and I have presented four 70-minute seminars, to an audience of 15 medical students at a time (about 60 in total) who had come to Prague from all around Czech Republic. The majority of students encountered the topic for the first time and had many interesting questions which we discussed. We addressed the following topics in our presentation: - History of psychedelic substance use in humans, from ancient ceremonies to the psychedelic renaissance, and lessons from the 70's. - Definition and classification of psychedelic compounds, and how the differ from other psychoactive molecules. - Mechanism of action of psychedelics and the resulting immediate and long-term effects, including potential dangers and adverse effects. - Differences between psychedelic experiences and psychosis, and non-pharmacological methods of inducing an altered state of consciousness. - Factors affecting the effect of psychedelics and outcome, such as set and settings. - Potential indications for psychedelic therapy and promising clinical trials currently in the works. - The research, education, and industry landscape in the field (which is surprisingly vast!) There was a lot to talk about, and it is impossible to cover this huge interdisciplinary topic in such a short seminar, especially with a heterogenous audience with students in different stages of their education, however, I believe we were able to speak about the important parts, and give the participants a general understanding of the field. I am humbled to have been invited to speak about this important topic which without a doubt concerns future medical doctors across many specialties. I believe it is important that health professionals are exposed to this rapidly growing field, and have a sober discussion of both its potential risks and benefits. This is the first time uniMIND Prague has taken part in a large event like this. It was a challenging feat and we have learned a lot from it. uniMIND Prague is determined to continue providing science-based educational opportunities at our journal clubs and other activities, where we welcome students and young researchers to engage in an open discussion about various aspects of our field and deepen their knowledge and understanding of the human mind. This is undoubtedly still a controversial topic of discussion for many, which means it should be spoken about even more, not less. In the words of the writer Isaac Asimov - "Any Book worth Banning, is a Book Worth Reading". I believe this applies to psychedelic science literature too. MIND Foundation #psychedelics #psychedelicresearch #psychedelictherapy #neuroscience #psychaitry #education #medicine #progress

Dear my LinkedIn network, Today I am being reflective and reflexive in what I am doing. As you may all know, I have been busy over the years preparing for national neurosurgical selection. This has been in the form of embarking on the Academic/Specialised Foundation Programme (neurosurgery orientated), completing my elective at University of Oxford within academic neurosurgery, conducted many a research project where I have co-authored and supervised, presented internationally, garnered academic prizes, completed a PGCert in Health Research at University of Leeds, started a part-time masters at Cambridge Healthcare Innovation University of Cambridge… basically been doing what I need to do to get in. But, after a shoddy FY1 year - I have realised that I am beginning to approach that process of “burn-out” - the realisation that everything I have worked and strived for is approaching in the form of national selection. As you all may know - I don’t just want to be a surgeon, but I want to be a prolific, someone who innovates, educates, leads, and above all else, manages patients to the best of my ability. There is much more to my career than standing on the conveyor belt of NHS career progression. Some people view the FY3 year (or so on and so forth) as a “clinical gap year” - which can be degrading to some. I see it as an opportunity to expand your skillsets, finetune your career aspirations, and above all else - destress from the trials and tribulations of the Foundation Programme. Despite ACF (Academic Clinical Fellowships) being released with a number of neurosurgery jobs being advertised, I have decided to NOT apply for training this year to focus on my ambitions as a healthcare leader, innovator, educator, and scientist. Some may think this is not the right move but to me after many a reflection, it’s the right thing to do. Please feel free to reach out. #NHS #FY3 #doctor #meded #innovation

A well put description of our obstacles as academic surgical trainees and how to tackle them.