Non cognitive Factors to Applying to Medical School: Mark Diaz M.D. (2013)
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Texila American University (TAU), Best medical school in Caribbean
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A University of Virginia medical student who thought he was just taking part in a training exercise is now being credited with potentially saving a mans life.

Med student Ryan Jones was participating in the standardized patient program at the medical school. Actors are assigned a specific condition that they pretend they have, then medical students try to figure out what is wrong with their patients by listening to their complaints and examining them.

Actor-patient Jim Malloy was told to portray the symptoms of an abdominal aortic aneurysm, which is when the main blood vessel that brings blood to the abdomen, pelvis and legs becomes enlarged. The condition can grow for many years without symptoms. It is most commonly seen in men over the age of 60 who have emphysema, genetic risks, high blood pressure, high cholesterol, obesity and who were or currently are smokers.

Left untreated, if the aneurysm expands too quickly it can burst open or leak blood along the blood vessel walls. This could lead to internal bleeding and death. Fast-growing aneurisms that are larger than two inches across are often candidates for surgical removal.

When Jones examined Malloy, he actually found an abdominal aortic aneurism. The student initially thought Malloy may have been a decoy, but thought it was best to mention that he detected something real.

"He thought I might have been a ringer that was planted in there to test him, and I had no symptoms, Malloy explained. He thought I was a plant with the real situation."

Malloy himself didnt know there was anything wrong with him.

I really didn't think anything of it until the supervising doctor told me they had discovered something, he said. Then I was concerned that Ryan found, felt an aneurysm."

Malloy had stent replacement surgery to remove the aneurism in August and has since recovered. His wife Louise saidshe was initially scared by the diagnosis.She said she is extremely thankful that Jones was able to detect her husbands medical problem before it was too late.

Dont ever think you cant affect a life, she said in apress releasethis week. My husband, Jim, is living proof that you can.

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Medical student diagnoses actor during practice exam, saves life

Since its inception more than a century ago, modern medical education has undergone a series of quiet revolutions, stretching and scaling to accommodate advances in biomedical science. Yet this comprehensive expansion in one critical area masks a relative neglect of another. Despite their staggering scope spanning genetics to geriatrics, and everything in between medical curricula today largely omit training on health policy.

The result? Even as today's medical students graduate with a deep scientific fluency, they leave all but illiterate when it comes to the healthcare system.

Consider, for example, the findings of a 2009 study in the journal Academic Medicine analyzing survey data from the Assn. of American Medical Colleges. Polling nearly 60,000 graduating medical students, the analysis found that less than half of the respondents felt they had an adequate grasp of health economics, managed care or healthcare systems. Compare this result to the corresponding statistic for clinical care, which clocked in at well over 80%.

Moreover, in a 2011 New England Journal of Medicine survey of medical deans, almost 60% of respondents reported their institution's curriculum as containing "too little" health policy training.

I can bear witness to this disparity firsthand. The curriculum of Stanford Medical School, where I am a deferred first-year student, does not incorporate a single required course on health policy or the healthcare system across four years and 249 credits of training.

And this oversight comes with consequences. To illustrate, recent research in JAMA Internal Medicine found that fewer than half of medical students nationwide understand even the basic components of the Affordable Care Act. On a systemic level, this illiteracy directly impedes our ability to institute meaningful health policy reforms that tackle such thorny issues as quality-based physician payments, comparative effectiveness guidelines or end-of-life care. Without willing and capable physician leaders to guide, implement and sustain such major shifts for the decades to come, reform efforts almost certainly will founder.

Consequently, efforts to rein in healthcare costs and improve patient outcomes must begin by modernizing medical curricula to incorporate health policy training. For example, a national mandate that fundamental knowledge of health systems be a prerequisite for medical licensing would encourage medical schools to incorporate course work on basic principles of health policy and economics. This teaching, moreover, should be nonpartisan and nonideological, focusing instead on the nuts and bolts of health systems akin to what law or business school students learn about policymaking and institutional governance.

This training need not be comprehensive or all-encompassing. Just as pre-clinical instruction in the medical sciences provides a basic foundation that is built upon in later clinical training, health policy education in medical curricula can offer a baseline understanding that is reinforced in subsequent years. Even ensuring just a rudimentary level of health

policy literacy could go a long way.

Furthermore, the advent of so-called massive open online courses, or MOOCs, means that financial concerns the costs of expanding medical curricula to encompass healthcare policy may be unwarranted. Online health policy courses, such as the one taught by physician/policymaker Ezekiel Emanuel at the University of Pennsylvania, could serve as a functional stand-in when a university lacks a department or set of instructors dedicated to health policy.

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The gap in medical education

Dec. 31, 2013 The imminent death of a patient is riddled with emotions for a patient and family as well as the medical team. A study based on the reflections of third-year Loyola University Chicago Stritch School of Medicine students is shedding light on the struggle physicians in training often face when trying to control their own emotions while not becoming desensitized to the needs of the dying patient and his or her family.

"Medical students are very aware they are undergoing a socialization process by which they become desensitized to the difficult things they see every day in the hospital. They realize this is necessary to control their emotions and focus on caring for the patients. On the other hand, they are very concerned about becoming insensitive to the spiritual, emotional and personal needs of the patient," said Mark Kuczewski, PhD, leader author and director of the Loyola University Chicago Stritch School of Medicine Neiswanger Institute for Bioethics.

The study published in the January issue of Academic Medicine, a peer-reviewed medical journal, focused on a randomized group of Loyola third-year medical students who were asked to write an essay reflecting on their personal experience as part of a team caring for a dying patient. The students were asked to think about patient care, communication, compassionate presence and personal/professional development. The assignment was given two months into their clinical rotation and was to be completed five months later allowing the student to complete five of their required clerkships.

The essays were coded using a multistep process and content-analysis approach. A bioethicist, physician and medical school chaplain independently read and coded the essays looking for emerging themes. The team then met together to compare themes and resolve discrepancies. Four themes emerged from the 68 student responses: communication, compassionate presence, patient care and personal and professional development.

The study found that conveying the prognosis of death to patients was understandably difficult -- but not just the manner in which it was conveyed, but also who conveyed it.

"Students observed how their teams delivered and explained the prognosis. Conversely they also wrote how teams avoided it," the study reported. "Students reported no matter how well a physician communicated a prognosis, families and individual family members absorbed and digested the information in their own manner and at their own pace."

The study also pointed out the importance of the medical team having a compassionate presence beyond routine medical interactions, such sharing interests, conveying affection or continuing to show interest in the patient after treatment had ended.

The study affirmed the importance of the medical care team understanding that a patient is body and soul, acknowledging there needs to be emotional and spiritual support for dying patients and their families.

"The students reported that some medical teams are very focused on the immediate medical problems. There is a fragmentation of medical care, such as teams rotating on and off service and patient transfers also that allows medical practitioners to avoid addressing the larger picture, death," Kuczewski said. This same fragmentation may cause practitioner to overlook patients' and families' needs for information and emotional and spiritual support.

The study determined that there is a need for emotional and spiritual support for the medical students and the health care team who are facing the loss of a patient as well.

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Study finds medical students concerned about becoming desensitized to dying patients

Jan. 2, 2014, 9:05 a.m.

University of Sydney says theCoalition should look at its proposal as an alternative to the rural medical school bid by CSU and La Trobe.

THE University of Sydney says its plan to combat rural doctor shortages uses the best part of the Charles Sturt University bid for a medical school but does not increase the demand on internship places.

Essentially it is the best of both worlds, says Dr Gabriel Shannon, the head of the University of Sydney's medical school.

Dr Shannon says the Coalition should look at the proposal as an alternative to the rural medical school bid by CSU and La Trobe.

The University of Sydney wants to shift 32 of its 229 Commonwealth-supported students to Dubbo and Orange.

That means more doctors trained rurally but it does not increase the number of graduates vying for limited internship places, unlike the CSU bid that would increase the number of graduates by 120.

Dr Shannon said there was already a bottleneck when it came to the number of graduates and the availability of internships they need to complete their training.

The University of Sydney runs a medical school in Orange at the Bloomfield campus where students study in Orange for 12 months.

"We'll still have students in the medical school for one year. This is an expansion of that program," Dr Shannon said.

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Student doctors could head west