Academic Medicine Podcast

In 2010, the Educational Commission for Foreign Medical Graduates (ECFMG) announced a new policy. Starting in 2023, all international medical graduates seeking ECFMG certification to complete graduate medical education training in the US must have graduated from a medical school accredited by an agency that has been formally recognized by the World Federation for Medical Education. Discussing this new policy and its workforce and other implications for physicians in the US and abroad are Sean Tackett (Twitter: @stacket1) and Dale Dauphinee and Academic Medicine editor-in-chief David Sklar and senior staff editor Toni Gallo (Twitter: @AcadMedJournal). Read more about this topic, including the articles discussed in this episode, at: journals.lww.com/academicmedicine…ges/default.aspx.

Discussing clinical reasoning, cognitive bias, and diagnostic error and their implications for physicians and training programs are editor-in-chief David Sklar and senior staff editor Toni Gallo (Twitter: @ AcadMedJournal) and Dan Mayer, an emergency medicine physician who has taught on diagnostic errors and medical decision-making for more than 30 years. Read more about this topic, including the articles discussed in this episode, at: https://journals.lww.com/academicmedicine/pages/default.aspx.

"Sometimes, it feels like the patient you work the hardest to save slips away, while the one you least expect to survive defeats the odds and walks away. Yet, somehow, we feel responsible for both patients. Is this duality a rite of passage or a yoke we must bear?" Parul Sud considers the dualities in medicine—failure and success, diffidence and confidence, despair and elation, the patients who survive and those who do not—and how physicians can learn and grow from them. Her essay was published in the Teaching and Learning Moments column in the March 2019 issue of Academic Medicine. Read her essay at academicmedicine.org.

"I firmly believe in the power of health education to improve health outcomes, and as I continue to work in culturally unfamiliar situations, I must meet patients where they are, understanding their beliefs and the realities of their environments, to ensure that my recommendations are truly culturally competent." Pre-med student John Rees recounts a presentation on healthy eating he gave to a community outside Oaxaca, Mexico. He describes how this community taught him about the importance of cultural humility in medicine. His essay was published in the Teaching and Learning Moments column in the March 2019 issue of Academic Medicine. Read his essay at academicmedicine.org.

"Yet, it felt to me like no amount of training would fully take away the difficulty of this conversation, the hollow feeling of negotiating the course of the final days of a human life. … As a future provider, I hope to have the courage to face these inevitable conflicts in values head-on, using the right dose of empathy to understand the perspective of the family when a loved one is dying." Medical student Arifeen Rahman remembers a family meeting that taught her about the importance of empathy and clear communication between patients, their families, and the care team. Her essay was published in the Teaching and Learning Moments column in the February 2019 issue of Academic Medicine. Read her essay at academicmedicine.org.

"I came into his room on a mission to complete one more routine task, and I left knowing that sometimes the most powerful medicine comes in the form of a tangible expression of humanity, the careful attention to the soul." Resident Cheralyn Hendrix remembers a patient who reminded her to choose compassion above all else because patients and their ailments are more than a list of tasks to be accomplished. Her essay was published in the Teaching and Learning Moments column in the January 2019 issue of Academic Medicine. Read her essay at academicmedicine.org.

"But it’s always a bit jarring to step from my work world to my home world ... After 15 years, I’m still trying to handle that transition with grace and to be as present at home as my work demands me to be every day in the hospital." Katherine Chretien reflects on the transition she makes each day between being present for her patients in the hospital and being present for her family at home. Her essay was published in the Teaching and Learning Moments column in the January 2019 issue of Academic Medicine. Read her essay at academicmedicine.org.

Joining editor-in-chief David Sklar and senior staff editor Toni Gallo (@AcadMedJournal) to discuss their personal experiences with parental leave and other policies that can help create more family-friendly training environments for physicians are recent and current residents Ariel Sklar, Alli Webb, and Michael Maguire. Guests also discuss the graduate medical education learning environment and the implications of these issues for trainees and their institutions. Read more about this topic, including the articles discussed in this episode, at: https://journals.lww.com/academicmedicine/pages/default.aspx.

How do we think about the entirety of a physician’s career? Discussing the individual, institutional, and workforce implications of physicians’ late-career transitions and retirement decisions in this new episode are editor-in-chief David Sklar, senior staff editor Toni Gallo (@AcadMedJournal), and authors Karen Leslie, MD, MEd (@karenraven) and Joanna Cain, MD. Read more about this topic, including the articles discussed in this episode, at: https://journals.lww.com/academicmedicine/pages/default.aspx. A transcript of this episode is available upon request from academicmedicine@aamc.org.

"I did not want to take for granted relationships with my loved ones—a girlfriend, a friend, a family member, a patient. For them I needed to create a new perspective, one where n = 1 and where the one in front of me matters most." Resident Adam Weiner reflects on balancing time spent on work and time spent with those he loves in this episode. His essay was published in the Teaching and Learning Moments column in the December 2018 issue of Academic Medicine. Read the essay at academicmedicine.org.

"He was hesitant, but truths spoken truthfully can make a world of difference between not-so-different strangers. And he liked that my subjects and verbs did not match, that my r’s rolled, and that my s’s turned into lisps. This part—this sound—was familiar to him." Physician Claudia Miranda reflects on an encounter with a patient who reminded her of her childhood, who reminded her of the connection between patients and doctors and the many ways they can be linked together. Her essay was published in the Teaching and Learning Moments column in the November 2018 issue of Academic Medicine. Read the essay at academicmedicine.org.

"I traced in my mind our timeline of visits every other month, as I got to know Lorraine and the rest of her family. We celebrated many triumphs and mourned countless setbacks together, relating to her health and to her kids." Physician Emily Gordon reflects on her memories of one patient, Lorraine, who taught her about the role family plays in healing and in health. Her essay was published in the Teaching and Learning Moments column in the November 2018 issue of Academic Medicine. Read the essay at academicmedicine.org.

"I wondered to myself … knowing what I now did, would I be comfortable seeing this patient again? Could I rely on myself to give careful, considerate thought to his overall well-being? Would I be willing to be his doctor?" Medical student Walter Klyce describes coming to terms with caring for a patient who made racist comments during a clinical encounter. His essay was published in the Teaching and Learning Moments column in the October 2018 issue of Academic Medicine. Read the essay at academicmedicine.org.

"We stood together, not as doctor and patient, but as lovers of the written word arrested by its enduring beauty." Internal medicine resident Dominic Decker describes connecting with a patient, not over her diagnosis or treatment but over their shared love of poetry. His essay was published in the Teaching and Learning Moments column in the October 2018 issue of Academic Medicine. Read the essay at academicmedicine.org.

Discussing the peer review process, specifically the practice of evaluating a scholarly article as a peer reviewer, are Academic Medicine editor-in-chief David Sklar and senior staff editor Toni Gallo and Carl Stevens, a master reviewer for the journal and a seven-time winner of the Academic Medicine Excellence in Reviewing Award. This episode is meant to be a resource for new and seasoned reviewers who want to improve their reviewing skills. Find more resources for reviewers at https://journals.lww.com/academicmedicine/Pages/ForReviewers.aspx.