4.4.25
Happy Friday!
Live The Question
Love the questions themselves, because the answer you find today might be irrelevant tomorrow.
The previous two weeks we have examined work life balance through vignettes of my mother and the eyes of Mark Scout investigating the questions of: 1) Is work/life balance something to be sought? 2) How does one not get swept away by the tidal wave of overcommitment compounded by emotional and physical strain in the medical field? and 3) What is the ideal amount of overlap between the public and private spheres of life?
This final week we will join Dr. Sarah Hufbauer in reminiscing on how the strawberry fields and study halls of UC Irvine impacted her medical education, centering around the question: how do you maintain a sense of self and personality while you are studying hard in the classroom?
The uniting thread between these four questions is relationship.
Dr. Sarah Hufbauer, a family practitioner at a federally qualified health center (FQHC) for more than 30 years, describes the way she studied not only allowed her to master the material but fostered relationships in the process of her medical education; relationships which endured past medical school and kept her head above water.
“The development of your voice has to be a blend or an integration between this foreign language that you're learning of medicine and what you already know from your studies in college and from your life experience.
I think the most successful integration of voices into an identity that doesn't feel foreign and feels authentic is through keeping in touch with people who know you from before. For example, your family or your friends. You have to explain material. How do I use language to translate between these two worlds? The me before med school and the me during medical school.
For example, we were learning all new terminology and all new concepts and to be able to do that in a group and not in a silo by yourself was amazing.
We would make fun games out of the material. I had one friend where we did almost all of our studying walking. We actually made physical cards, and we walked through strawberry fields rather than just being at a desk or in a library. So it felt like a group activity that included fun and our personality could come out in it. It wasn't like we were disappearing within it. We were more harnessing it into our own ways of learning that had previously worked for us, like learning through dance, through visual art, through experience in the pharmaceutical industry.”
Approaching education through the framework of your own skill sets and life experience is one which demands great imagination and is full of beautiful uniqueness to each person. Importantly, adapting material to your skill sets is not just relevant for teenagers and young adults beginning their education journey but also for adults who are transitioning to new careers and those who are retired. We are all lifelong learners, no matter the age. Don’t lose the spark of curiosity and the refining fire of a great question.
Medicine consistently demands your best as it is one of the only fields with mandated continuing education. Continuing medical education (CMEs) and Board Certification are two processes that all licensed doctors in America have to go through. This is an ongoing process, often done after hours or during vacation time.
In many medical specialties, after completing residency, physicians can choose to become "board certified." This is a voluntary process that signifies a physician has demonstrated expertise in a specific medical specialty by meeting certain educational requirements, passing rigorous examinations (both written and sometimes oral), and often undergoing peer review. While board certification is not legally required to practice medicine (a medical license is), it is often highly valued by patients, employers, and hospitals, and is often required for certain positions or insurance panels.
On the other hand, CME refers to educational activities that help medical professionals stay up-to-date with the latest advancements, best practices, and evolving standards in their respective fields.
CME activities can take various forms, including, but not limited to:
- Live Events: Conferences, workshops, seminars, grand rounds.
- Online Programs: Webinars, e-learning modules, online courses.
- Written Publications: Journals, newsletters, books.
- Audio and Video: Podcasts, video recordings of lectures.
- Performance Improvement Activities: Activities focused on improving clinical practice.
- Self-Assessment Activities: Activities that involve self-evaluation of knowledge and skills.
In short, doctors are lifelong learners. If you want to practice medicine, you have to be a scholar. The depth and breadth of your knowledge accumulated over a career can be quite expansive.
A Lifelong Learner
A paragon of lifelong learning, Dr. Jan Hirschmann is board certified in 3 different specialties: internal medicine, infectious disease, and pulmonary disease. He also studied Dermatology and Neurology but not long enough to be eligible to take the examinations. You may ask, why so many specialties?
Dr. Hirschmann cites a persistent focus on his weak and blind spots to become a one stop shop for all of the patients’ needs. In a 20 minute appointment at the end of his career, he could get most of your problems solved without having to be referred to another doctor and wait on another list for 3 months. He was the highest kind of student: focusing on his weaknesses to transform them into strengths.
In undergrad, he was an English major but fulfilled all of the pre-law, pre medicine, and general graduate school requirements to have options after he graduated. In his junior year, he decided that he would make a better contribution to society by being a physician than being an English professor. However, when reflecting on his time as an English major, he felt that studying English prepared him better than science major to pursue medicine:
“The reason is, at least in the way that science was taught at the time, science was just a certain amount of information which you had to memorize, whereas in English literature and history and some other similar liberal arts areas, what you needed to do is to weigh probabilities. For example, if you look at a line in poetry, you have to figure out what the meaning is.
There may be several different competing possibilities, and you have to weigh which meaning seems to be the most forceful, the most likely. And that's really more what we do in medicine. When we see patients, we have to weigh probabilities, decide what's more important, what particular elements that we see are more likely to be correct than other elements or more likely to lead to the correct diagnosis.”
The question is: how do you remember all of the information you learned over decades of practicing and studying to correctly weigh these probabilities?
Simple. There is a story, a name, a face associated with each disease or treatment or process. It is much harder to forget a face and a story than an image or bolded text in a textbook. Humane medicine is caring about the stories. In the story unites the answer, the problem, and, most importantly, the humanity of the person.
Our goal should be to create a system which facilitates the humanity of the physician to connect with the humanity of the patient at a national scale. Preventing medical education from hammering the humanity out of physicians is integral to the sustainability and regaining trust in our medical system.
Throughout my interviews with retired and aspiring doctors, they all shared the common trait of curiosity. All of them–no matter the age–I found to have an insatiable curiosity. There was always more to learn, more to become, more to discover in their presence. To be able to surround yourself with people you find inexhaustible is one of the greatest privileges in life.
Train Your Body and Mind
Finally, the combination of training your mind while training your body is an important rhythm to achieve this storied balance. There is an undeniable link between the health of your body and the health of your mind. Many retired and aspiring doctors praised the effects of consistent exercise and good nutrition.
Dr. Sarah Hufbauer found her resilience was always through exercise: running, swimming, or hiking. “I think that [exercise] still remains a place of refuge where I can let my worries go and be myself, a human without labels.”
Taw Bee, who is in the process of applying for medical school, found that it is “so important to be active, not only for your mental health, but for you to also connect with people outside of school and to just relax and hang out with other people for a while.”
Live the Question
A healthy man has many problems; a sick man only has one: to be healthy again. Since we are expecting a shortage of 86,000 physicians by 2036, it is vital for incoming and current doctors to prioritize their health. Don’t let the white coat reduce you to being one-dimensional. Stay in touch with your community, your hobbies, and your passions and let curiosity be a driving force in your life.
Be, as Samuel Johnson defined “curious” in his 1755 dictionary, “addicted to inquiry.”
Live the question, because the answer you find today might be irrelevant tomorrow.
Next Week: Creatively Financing Medical School
Be well!
Your friend,
Ian Scott
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Past Posts
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