Academic Medicine Podcast

As tears seeped from the corners of her eyes and stained her cheeks, I felt powerless. I reached for her hand, wishing I could offer my bare human hand instead of an impersonal blue latex glove. Holding her hand was the only thing I could do in the moment; I hoped it made her feel less alone. Natalie C. Spach, a fourth-year medical student at the University of North Carolina at Chapel Hill School of Medicine in Chapel Hill, North Carolina, reflects on the importance of physicians demonstrating compassion and empathy towards patients when they are at their most vulnerable.   The essay read in this episode was published in the Teaching and Learning Moments column in the May 2022 issue of Academic Medicine. Read the essay at academicmedicine.org.

The resident came into my room with one question and he got it answered. The rest was not his problem. But it was my problem. Arthur Garson Jr, clinical professor of health systems and population health sciences in the College of Medicine at the University of Houston in Houston, Texas, reflects on the importance of two-way communication between patients and physicians. The essay read in this episode was published in the Teaching and Learning Moments column in the May 2022 issue of Academic Medicine. Read the essay at academicmedicine.org.

Our patients should not be our blind spots. Even with the most thorough routines, I may not catch important clues—be it some subtle discomfort or altered affect—without keen observation, clues that may drastically change a patient’s story and care. Alan Z. Yang, a second-year medical student at Harvard Medical School in Boston, Massachusetts, discusses the importance of observing and truly seeing a patient during a visit rather than focusing solely on standard interview questions and physical exam. The essay read in this episode was published in the Teaching and Learning Moments column in the May 2022 issue of Academic Medicine. Read the essay at academicmedicine.org.

Guests Lala Forrest and Joe Geraghty join host Toni Gallo to discuss the journal’s Trainee Letters to the Editor feature. They highlight selected letters submitted in response to last year’s call for submissions about the role of trainees as agents of change and discuss how institutions can empower trainees to be leaders and how trainees can get started leading change efforts. Lala and Joe also introduce this year’s call about transformative moments in a trainee’s professional journey and describe what the editors are looking for in successful submissions. Available at academicmedicineblog.org are a transcript of this episode and links to the 2021 and 2022 calls for trainee letters to the editor and to the articles discussed in this episode. 

Our words and actions may strike others, or strike back at us, in unexpected ways. We must therefore always be ready to show our most human sides: to absorb surprising responses, lean into awkward moments, and apologize when we have erred. Aldis H. Petriceks, a third-year medical student at Harvard Medical School in Boston, Massachusetts, discusses the importance of setting aside the structure of the patient interview and embracing the patient as an authentic, living personality. The essay read in this episode was published in the Teaching and Learning Moments column in the April 2022 issue of Academic Medicine. Read the essay at academicmedicine.org.

In the following months, I started noticing a subtle change in the way my patients and the community saw me. I went from being called the doctor to our doctor. Sharon Reece, assistant professor in the Department of Family and Preventive Medicine in the College of Medicine at the University of Arkansas for Medical Sciences Northwest in Fayetteville, Arkansas, reflects on what she learned during her immersion in rural generalism in northern Alberta, Canada. The essay read in this episode was published in the Teaching and Learning Moments column in the April 2022 issue of Academic Medicine. Read the essay at academicmedicine.org.

These golden minutes were not only setting a realtime example of intersecting roles and responsibilities but opening a window into a version of mentorship unique to virtual platforms, a kind of role-modeling that revealed granular moments of sacrifice, struggle, and negotiation. Yoshiko Iwai, a second-year medical student at the University of North Carolina School of Medicine in Chapel Hill, North Carolina reflects on Zoom mentorship and the art of juggling medical practice, research, teaching, and family. The essay read in this episode was published in the Teaching and Learning Moments column in the March 2022 issue of Academic Medicine. Read the essay at academicmedicine.org.

In the ensuing weeks, I continued with my work, behaving as if the incident had no impact on me while clamping down the embarrassment of being called a racial slur in front of my team. When others asked how I was doing, I said that I was fine in an attempt to make it go away. Takesha Valentine Cooper, program director of the Psychiatry Residency Training Program and chair of medical school admissions, equity advisor, and vice chair for education in the Department of Psychiatry and Neurosciences at the University of California Riverside School of Medicine in Riverside, California discusses the importance of supporting historically marginalized medical students and residents who have faced discrimination. The essay read in this episode was published in the Teaching and Learning Moments column in the March 2022 issue of Academic Medicine. Read the essay at academicmedicine.org.

Guests Will Bynum, MD, and Joe Jackson, MD, join host Toni Gallo to discuss new research into the nature of shame experiences in medical students and emerging work on the implications of premedical students' shame experiences for their professional development. They offer advice for educators and learners for naming, normalizing, and addressing the effects of shame and provide suggestions for fostering a safe, inclusive learning environment and a holistic admissions process that support learners and minimize opportunities for shame triggering experiences.  Read the article discussed in this episode: Bynum WE IV, Teunissen PW, Varpio L. In the “shadow of shame”: A phenomenological exploration of the nature of shame experiences in medical students. Acad Med. 2021;96:S23-S30.  A transcript of this episode is available at academicmedicineblorg.org. 

This episode was originally released in August 2019. Guests Will Bynum, MD, Lara Varpio, PhD, and Ashley Adams, MD, join Toni Gallo and former Academic Medicine editor-in-chief David Sklar, MD, to discuss shame in medicine and medical education, what it is and isn't, how it can be studied, and their research and other work in this area. Read the articles discussed in this episode:  Bynum WE IV, Adams AV, Edelman CE, Uijtdehaage S, Artino AR Jr, Fox JW. Addressing the elephant in the room: A shame resilience seminar for medical students. Acad Med. 2019;94:1132-1136. Bynum WE IV, Artino AR Jr, Uijtdehaage S, Webb AMB, Varpio L. Sentinel emotional events: The nature, triggers, and effects of shame experiences in medical residents. Acad Med. 2019;94:85-93.  Sklar DP. Recognizing and eliminating shame culture in health professions education. Acad Med. 2019;94:1061-1063. A transcript of this episode is available at academicmedicineblog.org. Disclaimer: The views expressed in this episode are the authors’ own and do

Ultimately, whether it is through language, a shared interest, or another shared commonality, finding ways to connect with our patients is an invaluable skill that can transform medicine from a science into an art. Avani M. Kolla, a fourth-year medical student at New York University Grossman School of Medicine in New York, New York, reflects on how language can act as a stepping stone to forming relationships between patients and providers. The essay read in this episode was published in the Teaching and Learning Moments column in the February 2022 issue of Academic Medicine. Read the essay at academicmedicine.org.

I realized I never processed what I witnessed, experienced, and lived through. I put it all in a box so I could keep going to work. I sealed the box so that nothing could escape and distract me from the mission at hand: caring for critically ill patients. Amanda S. Xi, a critical care anesthesiologist in the Department of Anesthesia, Critical Care and Pain Medicine at Massachusetts General Hospital in Boston, Massachusetts, discusses how institutions can help trainees who experienced trauma while caring for patients during the height of the COVID-19 pandemic. The essay read in this episode was published in the Teaching and Learning Moments column in the January 2022 issue of Academic Medicine. Read the essay at academicmedicine.org.

I choose to view this not as a story of bias against me, but instead of my attending’s patience and perseverance. His uncompromising kindness made the patient blind to his own preconceived notions. I try to be a role model for my own residents the way that he was for me. Deepa Danan, assistant professor and medical student clerkship director in the Department of Otolaryngology at the University of Florida in Gainesville, Florida, reflects on remaining compassionate when caring for patients, even when they make misjudgments about their providers. The essay read in this episode was published in the Teaching and Learning Moments column in the December 2021 issue of Academic Medicine. Read the essay at academicmedicine.org.

The formative experience I had long sought emerged outside the context of feedback itself. I had spent my rotation in search of people who would change me, but I had not expected to find them dressed in johnnies rather than long white coats. Grace Ferri, a fourth-year medical student at Boston University School of Medicine in Boston, Massachusetts, reflects on the patient who helped her remember where she came from, and—most importantly—where she belonged, during a stressful day on the wards. The essay read in this episode was published in the Teaching and Learning Moments column in the December 2021 issue of Academic Medicine. Read the essay at academicmedicine.org.

With the mask muffling my voice and the omnipresent sound of monitor alarms, words too, were strained. I grew irate at the situation. The inability to talk. The inability to connect. The inability to touch. Graduate nursing student Hunter Marshall reflects on isolation and connection during the chaos of the COVID-19 pandemic. This essay placed first in the 2021 Hope Babette Tang Humanism in Healthcare Essay Contest and was published in the December 2021 issue of Academic Medicine. Read the essay at academicmedicine.org.

Even in the age of medical miracles, there is still no intervention more powerful than a genuine human connection. There is no lab, no scan, no test, no drug, no surgery, that can replace it. For the soul heals not by human medicine, but human kindness. Medical student Ross Perry reflects on the most important lesson he learned while caring for a very special patient during his third year of medical school. This essay placed first in the 2021 Hope Babette Tang Humanism in Healthcare Essay Contest and was published in the December 2021 issue of Academic Medicine. Read the essay at academicmedicine.org.

Dementia does not rob the ears of joy. Recent nursing school graduate Anna Swartzlander remembers a patient with dementia who shared with her his love of music. This essay placed second in the 2021 Hope Babette Tang Humanism in Healthcare Essay Contest and was published in the November 2021 issue of Academic Medicine. Read the essay at academicmedicine.org. 

Why do I find it so much easier to deal with death after the fact than I do watching its slow, looming approach, like the shadow of a cloud creeping over my face? I think of cupping water between my hands, the spaces between fingers that I cannot hold tight. Medical student Davy Ran reflects on how their perspective on death has changed since they began medical school. This essay placed second in the 2021 Hope Babette Tang Humanism in Healthcare Essay Contest and was published in the November 2021 issue of Academic Medicine. Read the essay at academicmedicine.org.

“My time, energy, and focus are finite; one clear, properly motivated action will come at the cost of another. It is easy to think this means I will miss out on important moments, or that I may disappoint some for the benefit of others. But the antidote is to recognize that each experience is special.” Fourth-year medical student Fletcher Bell reflects on doctors’ overlapping duties to their patients and family. This essay placed third in the 2021 Hope Babette Tang Humanism in Healthcare Essay Contest and was published in the October 2021 issue of Academic Medicine. Read the essay at academicmedicine.org.

Guest Deena Hamza, PhD, joins hosts Toni Gallo and Research in Medical Education (RIME) Committee member and assistant editor Dan Schumacher, MD, PhD, MEd, to discuss a new framework for evaluating innovations, including why and how this model was developed and the ways it can be used in medical education. This is the third episode in a 3-part series of discussions with RIME authors about their medical education research and its implications for the field. Find the complete 2021 RIME supplement, which is free to read and download, at academicmedicine.org. Read the article discussed in this episode: Eco-Normalization: Evaluating the Longevity of an Innovation in Context. A transcript of this episode is available at academicmedicineblog.org.