Harvard Medical Student Review

Harvard Medical Student Review The Harvard Medical Student Review (HMSR) is a student-run medical journal publishing scholarly articles, reviews, editorials, and original artwork.

Primary Care Selection and the Financial Burdens of Medical Education"Preventative medicine and primary care services ar...
11/01/2022

Primary Care Selection and the Financial Burdens of Medical Education

"Preventative medicine and primary care services are the foundations to building healthier communities. Unfortunately, the resources are often limited, and it is estimated that by 2032, the United States could face a shortage of up to 21,000 to 55,200 primary care physicians [1]. This number may be even larger as the impact of the Covid-19 pandemic has yet to be seen. This deficit of physicians is even more pronounced in rural areas where residents are almost five times as likely to live in a county with a physician shortage [2]. There are a multitude of factors that contribute to this decline in workforce, but one pressing issue is the impact of medical student specialty selection. According to AAMC, specialty content and personality fit are always ranked as top reasons for specialty selection, while debt ranks much lower [4]. Despite this, numerous medical schools have begun to offer full tuition or scholarships in the hope that a debt free education will encourage more students to select primary care. In this commentary, we discuss the Geisinger Abigail Scholars Program which is a program offering free medical education and a living stipend in exchange for a commitment to Geisinger employment in primary care fields upon residency completion. One of the scholars offers her unique perspective as to why she selected this program and how this initiative can reinvigorate primary care interest, while serving as a model for other medical schools."

Christin Spatz, MD [1], Kara Romanowski [1], Tanja Adonizio, MD [1], and Michelle Schmude, EdD [1]
1- Geisinger Commonwealth School of Medicine

Please check out the full article at http://bitly.ws/w35C
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Integrating a Smoking Cessation Initiative for the Uninsured at a Student-Run Free Clinic"Cigarette smoking is the leadi...
10/16/2022

Integrating a Smoking Cessation Initiative for the Uninsured at a Student-Run Free Clinic

"Cigarette smoking is the leading cause of preventable deaths and diseases in the United States. Student-run clinics play an invaluable role in connecting underserved patients with preventative care. To reduce smoking in uninsured communities, the University of Missouri student-run free MedZou Community Health Clinic developed a Smoking Cessation initiative as part of a preventative health service in 2013. Patients utilizing the smoking cessation services receive a combination of motivational interviewing, patient education, and pharmacotherapy. There is currently limited literature on the structure and implementation of student-run preventative health clinics. The smoking cessation initiative described here can provide an example for other student-run clinics to successfully implement similar programs."

Cynthia Y Tang, BS [1]*, Lauren E. Flowers, BS [1]*, Emra Bosnjak, BS [1] , Tricia Haynes, MS [1] , Jamie B. Smith, MA [2] , Laura E. Morris, MD, MSPH [2]

[1] School of Medicine, University of Missouri
[2] Family and Community Medicine, University of Missouri
*These authors contributed equally to this study

Please check out the full article at http://bitly.ws/vqYy

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Completing the Results of a Pan-Canadian Survey on the State of Oncology Education in Family Practice Residency Programs...
10/15/2022

Completing the Results of a Pan-Canadian Survey on the State of Oncology Education in Family Practice Residency Programs: Comparison of One Province to the Rest of Canada

"Introduction: The incidence and prevalence of cancer in Canada is rising, and family physicians will increasingly provide care at all stages of a patient’s cancer journey. This highlights the importance of adequate oncology education in family practice training programs. A survey study done in 2017 to assess the state of oncology education in Canadian family practice residency programs did not include the University of British Columbia (UBC). The purpose of our study was to obtain this data for the UBC family practice residency program and to compare the results to those from the rest of Canada.
Methods: A web-based survey was emailed to UBC family practice residents and program directors. The survey assessed depth of the oncology curriculum, current teaching methods and perceived gaps. Results were compared to the non-UBC survey data and interpreted with descriptive statistics.
Results: 54/348 UBC family practice residents and 10/20 program directors completed the survey. 3% of UBC and 7% of non-UBC family practice residents felt their program adequately prepared them to care for oncology patients. There was uniformity among all participants in ratings of perceived importance of a list of oncology topics expected to be covered in training for residents. There was discordance in the perceived frequency of topics taught between all family practice residents and program directors.
Conclusion: This study can inform further development of oncology specific curriculum in family practice residency programs. Further study is required to understand areas of discordance between family practice residents and program directors."

Alanna Janz [1], Lisa Wang [2], Svetlana Bortnik [2] , Jaspreet Garcha [2], Vincent Tam [3], Steven Yip [3], Paris Ann Ingledew [4]

[1] Faculty of Medicine MD program, University of British Columbia
[2] Family Medicine Residency Program, University of British Columbia Surrey-South Fraser
[3] Tom Baker Cancer Centre; Department of Oncology, Cu***ng School of Medicine, University of Calgary
[4] Department of Surgery, Division of Radiation Oncology, Vancouver Cancer Center, BC Cancer Agency

Please check out the full article at http://bitly.ws/vqLy

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A Look at South Korean Plastic Surgery"With increasing globalization in communication, travel, economics, and innovation...
10/13/2022

A Look at South Korean Plastic Surgery

"With increasing globalization in communication, travel, economics, and innovation, medicine and plastic surgery have also made great advancements. The following essay looks at plastic surgery in South Korea, and the innovations South Korean plastic surgeons have made in the field. We explore the cultural, societal, and economic influences that may have impacted the development and popularity of plastic surgery in South Korea, and the rise of South Korean medical tourism. We also compare South Korean plastic surgery versus American plastic surgery, showing differences and similarities in procedures performed, costs, and in patient demographics. Additionally, we look at the possible impacts of plastic surgery on mental health. Finally, we conclude with a discussion that highlights the importance and incredible potential of cross-cultural communication and collaboration for the prospective advancements that we, in America, could learn, adopt, and create."

Annie Jin and Ian Whittall
University of Connecticut School of Medicine

Please check out the full article at http://bitly.ws/vjkZ

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Vibration-based Microphones as a Solution for Non-invasive Ventilation Related Communication Impairment"The incidence of...
10/08/2022

Vibration-based Microphones as a Solution for Non-invasive Ventilation Related Communication Impairment

"The incidence of acute respiratory failure (ARF) has dramatically increased in the past few decades in the United States. From 2002 to 2017, there was a 197% increase in the annual incidence of ARF, and in response, a 437% increase in the use of noninvasive mechanical ventilation (NIV). Multiple studies have demonstrated that use of NIV frequently causes communication impairment (CI), which is strongly associated with anxiety and can in turn contribute to NIV intolerance and failure, and ultimately, mortality [8-10]. CI also prevents accurate evaluation of patients by providers, which can contribute to worse clinical outcomes [11]. Recently, Lee et al at Pohang University, South Korea, published their development of a flexible, wearable vibration sensor that can amplify speech while minimizing ambient noise. Although this device is intended for use in portable devices such as cell phones, it also poses as a viable solution for NIV-related communication impairment. Use of this vibration-based microphone can help address NIV-related CI and significantly improve clinical outcomes in patients with acute respiratory failure."

James Lee
Carle Illinois College of Medicine

Please check out the full article at http://bitly.ws/vaXn

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About Time: Making Space in the Classroom for Students’ Experiences of Trauma"Many medical students have experienced tra...
10/07/2022

About Time: Making Space in the Classroom for Students’ Experiences of Trauma

"Many medical students have experienced trauma and conditions affecting their mental health. Throughout medical school, especially during psychiatry portions of the curriculum, students and educators may face challenges navigating course material. Adverse classroom and patient interactions can lead to further traumatization, isolation from course content, and lapses in professionalism. Contemporary educational environments have become increasingly sensitive to the prevalence of trauma among students, but debate remains over how to simultaneously respect student needs and ensure engagement with important course content. In medical education, a major challenge is to create learning environments that are attentive to students’ well-being, while preparing students to encounter clinical scenarios they may find distressing. Principles of trauma-informed medical education (TIME) support medical educators and medical students to work together to create curricula and learning environments that are psychologically safe and appropriately challenging. As students engage with difficult course content at a suitable pace with support, they build resilience, embrace growth and learning, and become better able to manage challenging clinical scenarios as future physicians."

Christine Xu [1], David A. Hirsh, MD [2], Jennifer C. Kesselheim, MD [3]

[1] medical student at Harvard Medical School, Boston, MA.
[2] Associate Professor of Medicine, Harvard Medical School/Cambridge Health Alliance, Boston and Cambridge, Massachusetts.
[3] Director of the Master of Medical Sciences (MMSc) in Medical Education program at Harvard Medical School, the Director of the Fellowship in Pediatric Hematology-Oncology at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, and an Associate Professor of Pediatrics at Harvard Medical School.

Please check out the full article at http://bitly.ws/v2T5

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Medical Student Perspective on Resident Maternity Leave Policy"Since 2017, women have comprised the majority of enrolled...
10/07/2022

Medical Student Perspective on Resident Maternity Leave Policy

"Since 2017, women have comprised the majority of enrolled U.S. medical students, marking a milestone in the gradual diversification of America’s next generation of physicians [1]. We represent six of these female medical students from schools across California. As members of the American College of Physicians California Council of Student Members Women in Medicine Committee, we aim to identify and address unique challenges female physicians and trainees face in the career of medicine while advocating for their equity in well-being, compensation, and career advancements."

May M. Kyaw [1], Angela Pham [1], Gaia Linfield [2], Zoe Burger [2], Sara Toulouie [3], and Olivia Yang [4]

[1] David Geffen School of Medicine at UCLA
[2] University of California, San Francisco School of Medicine
[3] California Northstate University College of Medicine
[4] California University of Science and Medicine, School of Medicine

Please check out the full article at http://bitly.ws/v2B2

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Colorectal Cancer Screening During COVID-19: FIT testing as the Suggested Solution"In March 2020, healthcare in the Unit...
10/06/2022

Colorectal Cancer Screening During COVID-19: FIT testing as the Suggested Solution

"In March 2020, healthcare in the United States changed, with primary care and preventative care, particularly colorectal cancer screening, grinding to a halt. COVID-19 brought to the forefront the racial healthcare disparities in the United States with the pandemic disproportionately affecting minority communities, reflecting the well-established disparities in colorectal cancer outcomes which are expected to be exacerbated by the lack of screening. This article aims to promote the use of FIT testing for colorectal cancer screening during this pandemic particularly for minority communities. Studies have shown that FIT tests have a high sensitivity and specificity, are inexpensive, and have better adherence than colonoscopies. Given the cancellation of many screening colonoscopies and the potential risk of leaving the house for a procedure, implementation of a FIT screening program appears to be the best intervention for maintaining colorectal cancer screening during COVID-19 and preventing the cancer disparities from worsening."

Aleeza J. Leder Macek, B.Sc.
New York University Grossman School of Medicine

Please check out the full article at bitly.ws/v2Aj

HMSR Issue 7 is online now! Link in bio.
10/04/2022

HMSR Issue 7 is online now! Link in bio.

Advancing Preclinical Medical Education through High Fidelity Simulation and Standardized Patient Families"Our results s...
05/05/2022

Advancing Preclinical Medical Education through High Fidelity Simulation and Standardized Patient Families

"Our results show that students find simulated encounters to be beneficial during their clinical rotations. According to the survey responses in this study, simulated encounters were more beneficial for some rotations, like Internal Medicine, rather than other rotations. When asked which rotation benefited the most from these encounters, 44/85 of students selected IM rotations. In reviewing the written responses, many students commented that the simulated encounters were overall helpful to their education, however, the simulations will never be able to replace real clinical encounters. Since the simulated encounters take place during the second year of medical school before clinical encounters, these encounters may help build the foundation for third year medical students and beyond."

Benjamin W. Cooper [1], Nicholas A. Jaeger [1], Maureen A. Hirthler [1], and Cathy J. King [2]

1 -Lake Erie College of Osteopathic Medicine
2 -State College of Florida, Manatee-Sarasota

Please check out the full article at https://bit.ly/3KtlHm9

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Too Loose, Too Tight, But Never Just Right: Adhesions, Aspirations, and Atelectasis"Biofilms are cool, bacteria are cool...
05/04/2022

Too Loose, Too Tight, But Never Just Right: Adhesions, Aspirations, and Atelectasis

"Biofilms are cool, bacteria are cool, and the way that bacteria have evolved to work together is incredible, kinda spooky, and has important implications on the evolutionary history of multicellularity as well as potential clinical applications.
Let’s back up a second - what exactly are biofilms? Biofilm, a term coined in 1978 though the discovery of these structures’ existence dates back to the 17th century (Banthia et al, 2011), refers generally to a multicellular community of microorganisms encased within an extracellular matrix, invariably involving multiple species (Lopez et al, 2010). This extracellular matrix protects the encased bacteria from antibiotics and other methods of destruction, and in these states biofilms and their biological components can persist in the body for long periods of time. These films are present almost everywhere, from our teeth in the form of dental plaques to ships and pipes and even in geothermal vents."

Layla Siraj
Harvard Medical School

Please check out the full article at https://bit.ly/3y6oPSq

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Reducing Childhood Respiratory Infections through Interventions in Indoor Household Air Pollution in Rural Underdevelope...
05/03/2022

Reducing Childhood Respiratory Infections through Interventions in Indoor Household Air Pollution in Rural Underdeveloped Countries

“The current study reviewed various cooking-related interventions taken to decrease childhood respiratory illness in developing countries. Findings regarding the use of clean fuel over biomass fuels were controversial. While most studies found significant associations between the use of biomass fuels and respiratory infection, a handful of studies found a lack thereof. Notably, however, no studies found increased risk while using cleaner fuels and thus it seems that homes adopt no risk of harm with use. Although the current review does not assess the feasibility of interventions, the recommendation of clean fuel use in clinical practice may be warranted. As for stove-related alterations, effects were largely dependent on the specific intervention used; while the chimney stove intervention in the RESPIRE trial decreased severe pneumonia, the stoves used by Mortimer et al [27] with improved combustion efficacy had no significant effect on childhood respiratory infections. While less research has investigated the use of behavioural interventions, removing children from the kitchen while cooking was consistently associated with decreased respiratory infections. Behavioural interventions, such as this, require no implementation fees, maintenance costs or training and thus may be of particularly important use in decreasing respiratory infection in children."

Lisle Blackbourn and Erin Walton-Ball*
*co-first authors
Royal College of Surgeons in Ireland, School of Medicine

Please check out the full article at https://bit.ly/3vnn0ih

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The Harvard Medical Student Review (HMSR) is a student-run medical journal. Our mission is to provide a platform for students to contribute to important issues facing health and medicine through scholarly articles, commentary & editorials, interviews, and original artwork. Contributions are invited from the Harvard medical, dental, and public health schools, and extends to all graduate students at all institutions.