The Inaugural “Penn Talks” Competition

An inside scoop on a new event for Penn Med students!

This past year has been an exciting one. I applied for residency in internal medicine and took some unforgettable elective rotations. Actually, as I’m writing this post, Match Day is only a week away! The most exciting part of this year, though, was seeing months of planning come to fruition in the PennTalks Teaching Competition.

Back in September 2015, I went to the administration with an idea: let’s hold a competition where students compete against one another to give the best 8 minute talk they can on a topic of their choice. Each competitor would be paired with a faculty mentor, to help them refine their talk. The winner would be selected by a panel of “celebrity judges” (read: the student body’s favorite faculty), with the audience voting, as well. This TedTalks-meets-American Idol event would be advertised to the entire School of Medicine and celebrate how much we can teach each other as Penn medical students. Ultimately, the administration liked our pitch and gave us the go-ahead. Although a lot of work lay ahead of me and the rest of Penn’s Medical Education Club, I couldn’t have been more excited.

Want to know how excited we all were? See for yourself:
LEAKED Penn Talks Training Video

After many months of planning and preparation, on February 25th, 2016, the first annual PennTalks Teaching Competition opened to an auditorium full of Penn medical students and medical school faculty. Our eight competitors, chosen from a pool of initial entrants, spanned all 4 medical school classes. Their talks covered a wide array of interesting topics. Examples included “Keeping Creativity Alive in Medicine,” “How to Insert an Ultrasound-guided IV,” “What are My Chances, Doc? – Why Biostatistics Are Important to Everyone,” and “What a Whale can Teach Us about the Human Body.” This year’s winner, Natalie Stokes, a 4th year applying in Internal Medicine, gave a stellar talk entitled “The Science of Swole: What are in those GNC Supplements Anyways?” All of the talks were fantastic, and everyone learned something new during the event.

JFL_0099Casey McQuade, MS4 and co-president of the Medical Education Club, explains the rules for the night to the panel of celebrity judges.

The success of this event demonstrates two key points about Penn. First, we have an administration who listens to our ideas and is willing to partner with us to make our ideas a reality. Without the support of our administration, and the faculty members who were either judges or mentors, the Teaching Competition would have remained another unfulfilled “good idea”. Second, our students are rooting for each other, and we naturally want to see our peers succeed. That willingness to share what we know with one another makes Penn students truly outstanding, and makes the School of Medicine a wonderful place to become a doctor.

JFL_0412Natalie Stokes, MS4, launches into her award-winning presentation.

Casey McQuade is a fourth year student who matched in Internal Medicine. He is interested in cardiology and general internal medicine, and served as the co-president of the Medical Education Club at Penn. 

Mentorship at Penn Med

At Penn Med, “mentorship” is more than just a buzzword. An MS3 shares her perspective on the culture and community of mentoring at Penn.

When I think back to May 13th 2013, less than 48 hours before the equally exciting and fearful May 15th deadline (aka the day which “you must pick one, and ONLY one medical school to attend,”) I am pleasantly reminded as to why I chose to attend medical school at the University of Pennsylvania. I think back to that afternoon where I found myself sitting at my kitchen table with my older brother, who is also a physician. I was making the painstaking decision between attending medical school close to the comforts of home, family, and friends at my alma mater or moving to the East Coast in order to attend the Perelman School of Medicine at the University of Pennsylvania. While my brother knew months prior when I was accepted to UPenn that I would be matriculating here for medical school, he sat patiently while I resorted to my handy-dandy “T-diagrams” and allowed them to fulfill their timeless role as a “pros and cons” list, one for each school. About half way through my first list, my brother appropriately nudged me along in my decision making. He simply asked, “Liz, what is holding you back from admitting that you belong at Penn? The hard part is over… they’ve already accepted you! Now all that you have to do is GO!” While even he had to smirk at his over simplification of my just having to “go” to the East Coast, my response was more insightful than expected. I replied with the honest answer that I was hesitating out of fear—I would be moving to a new city where I had no family, no friends, and would unfortunately have to face my fear of flying at least twice a year! I expressed that what I needed was to have someone like him, like family, at Penn. Someone to have my best interests in mind and, of course, tons of patience and encouragement for all of my sure-to-come struggles. He took my list and added “mentorship” to the “pro” section for UPenn. Sibling rivalry usually limits my acknowledgment of how smart my brother may be, but I have to admit, he sure knew what he was talking about this time.

While the concept of mentorship may not be unique to UPenn, I do believe that it is uniquely applied here. At every level of the “medical school hierarchy” connections are constantly being made, upheld, and expanded upon, whether that be between medical students in the same year, different years, with residents, attendings, post-docs, etc. To be honest, though the term “hierarchy” certainly serves a historical and legal purpose within the medical community when distinguishing student from resident from attending, it just doesn’t feel correct to apply to Penn. If I had to describe the relationship of academics at Penn Med, it would be best described as a ‘web’ comprised of multiple layers of closely interwoven thread, all of which rely on connections with others to maintain its tension and strength. The building of your “Penn web” begins during your first week of orientation when you are assigned to your “learning team”, a random grouping of 6-7 students with whom you share the most time during your first year and a half of med school While taking ‘team exams’, synergizing in small groups, and taking classes together, whether or not you realize it at the time, you are also mentoring one another. With the beyond impressive students at Penn, and their incredible variety of backgrounds and experiences, it really should have come as no surprise that my classmates have offered me some of my best mentor and mentee interactions, an asset that cannot be highlighted enough as clerkships are now off and running!

In addition to the supportive infrastructure Penn Med students offer one another, the impressive faculty are a key distinguishing feature at Penn. In all honesty, this exact paragraph was written after a prolonged period of writer’s blocker encouraged me to check my inbox, and I had three emails, from three different mentors, currently in three different states, still taking the time out of their busy schedules to respond to emails and offer advice or project ideas. I have never felt so supported as a student, future physician, but most importantly, as a person by this university. With time built in to our curriculum for a scholarly pursuit, we are constantly encouraged to interact with our faculty and peers. Often meetings which begin with discussions about research projects conclude with encouragement, guidance, and most importantly, a sense of genuine support as we trudge forward in our careers. I may not know exactly what field of medicine I will end up in or where I will be practicing, but I am confident that UPenn has and will continue to provide my classmates and me with the necessary tools to pursue and accomplish our goals.

Elizabeth Messenger is a 3rd year medical student at the Perelman School of a Medicine. She is currently interested in pursuing a career within dermatology. In her free time, you can find her on the volleyball or basketball courts.

Learning Teams

Learning teams are a unique and central component of the Penn Med curriculum. An MS3 shares his experience and perspective on how his learning team has shaped his medical education.

I don’t know that I really appreciated the role of Learning Teams before starting at Penn, and I think that it’s difficult to. I was told that we’d be working in groups together, and that we’d become really close, but that didn’t seem too new to me. I’d worked in groups before.

You meet your Learning Team in the first few days of orientation as you’re taken to an off-campus retreat. Each incoming medical school class is divided into 12 Doctoring Groups, and each Doctoring Group is home to two Learning Teams of 7-8 students each. During the retreat, which is modeled closely off of the Wharton orientation, you go through all sorts of team-building exercises – you write skits, build tools, and generally reflect on how well you cooperate. We were told that business schools have long known how to enrich the leadership and collaborative skills of their students, and this is why the medical school has taken much of the exercises and general philosophy of Learning Teams from Wharton. It made sense to me.

Your Learning Team then guides you through the first 1.5 years of pre-clinical learning at Penn. There are certainly exceptions – you pick your own anatomy team of 4, and some of the discussion groups in Genetics and Epidemiology are arranged based on prior knowledge – but for the most part you work through problems with your Learning Team. Courses are typically structured with lectures in the morning followed by separate discussion-based problem solving sessions (“small groups”) where your learning team will work relatively independently and get assistance from circulating professors. Based on the course, small groups might entail reading clinical cases and answering questions, going through EKGs, or interpreting digital histology slides. When you work with the same group for roughly 2 hours per day, every day, you learn a lot about how the group functions and what needs to be done to ensure future success. Our group would have different “drivers” for each session, and these leaders gave our group direction and organization. Sometimes the driver was the one most familiar with that particular material, occasionally the driver was someone who had lots of questions and would take us through the session more methodically, and not infrequently the driver was simply the last person to arrive to class. We spruced up these sessions with snacks, and made a point to celebrate everyone’s birthday during small groups. Overall, seeing everyone day in and day out, and having no choice but to work and learn together, brought us all closer. There were few secrets, except for the one time when we were trying to schedule a group meeting in the afternoon and one member kept saying he was busy at each proposed time. Frustrated, we asked him what he was doing and when he’d be free, and he finally revealed to us that he driving out of Philly to buy/adopt a hedgehog. … Ok. We didn’t appreciate the secrecy, but we discovered a lot that day about keeping a hedgehog as a pet.

That isn’t to say that groups never have issues, and certainly there were tenser moments when material was difficult or when there were time pressures for finishing our work. One unique aspect to the Learning Teams relative to other group work is that most of the tests at Penn Med have a team component. What’s the best way to write down one concise answer to an open-ended question when there are 7 people, each with their own ideas and preferred phrasings? I’m still not sure that there’s a clear recipe for success, and I’m sorry Annie that you got stuck so often being the “scribe”. The process teaches you valuable lessons for teamwork and communication, and Penn makes sure to build in de-briefing sessions to reflect on your team functioning and any inter-personal conflicts. We strove to plan potluck dinners and social outings to maintain the health of our group too.

The Learning Team is also the group in which you first learn how to interact with standardized patients (actors portraying clinical scenarios, to teach out how to approach the doctor-patient relationship). I sat in front of my 6 teammates and a professor as I first struggled to interview friendly, then sad, then racist standardized patients. It was nerve-wracking to be observed in that way, but I’d much rather have done it in front of those close friends than others whom I didn’t know as well. Maybe that’s what why the Learning Team bonds are so tight – not only do you spend time together, but you succeed together, struggle together, and learn how to be vulnerable with each other. I’ve opened up to my Learning Team members in ways that would be rare with other friends, and that’s become especially true as we’ve transitioned into the clinical part of our training.

Now, on our clerkship rotations, we have Doctoring sessions with our two Learning Teams once per month rather than once a week. We talk about the stresses of adapting to the hospital routine, the mental demands of studying for standardized shelf exams, the exhaustion after working night shifts, the emotional burden of dealing with patients dying, and any other personal concerns that come up during what is certainly a transformative year. We also deal with the high points – the rotations that have inspired us, the moments that reaffirm our desire to go into medicine, and the paths we see ourselves heading down.

In one of our first potluck dinners at the beginning of medical school, we went around the room and took guesses at peoples’ future specialties. At that point it was based purely on initial impressions and personalities. We did a similar check-in recently, and it was informative to see how people have discovered their passions and molded their visions for the future. I can’t believe how far we’ve come and how much we’ve experienced together in the last 2+ years, and I’m grateful to have had the Learning Team structure to support all of us along the way.

Nilan Schnure is an MS3 from Bethesda, MD. He studied molecular biology at Princeton University before working for a year in clinical research at the UCSF Breast Care Center. In college he ran track and sang, which he’s tried unsuccessfully to do simultaneously to make the most of his free time during clerkship year.

Welcome from an MSTP student!

In every Penn Med class, about 15 of the 160 students are part of the school’s robust  MD-PhD program. Today, a second year MD-PhD student shares her interest in pursuing a combined degree, integrating medical training with graduate research training.

Alo!

My name is (Elena) Alejandra Guevara Mendez. I am from San Juan, Puerto Rico and studied Molecular Biology at the University of Puerto Rico, Rio Piedras (UPR-RP), and am currently a first year MSTP  (Medical Science Training Program) student at Perelman School of Medicine.

When I was in high school, I could think of no other profession I wanted to pursue more than being a writer. I was set on studying Literature and Languages, maybe move to Paris for a bit, and entertain thoughts and play with words for a living. My very Puerto Rican mother pulled my head out of the clouds and, of course, wouldn’t let me (and God forbid you cross a mother such as mine). So when senior year rolled around, I decided that the only other thing I could see myself studying was science, and in PR, if you study science, that pretty much automatically dictates that you’ll apply to medical school.

Fast forward four years and since I still couldn’t decide what I wanted to do with my life, so I kept my options open. I spent about two and a half years working in my lab in PR before applying for the MSTP program. Research is hard, time consuming, frustrating, and competitive- it is not easy, and not for everyone. You need to spend real time in a lab on a project that you can call your own to really know if it’s something that you want to really do. For me, research is an avenue to entertain thoughts and ideas in a way that is very difficult to do in a clinical setting.

The approach to addressing medical questions and considerations in basic science research, as well as in more translational bench to bedside research, varies greatly from the approach in clinical settings. In the clinic, you are applying what is already true and tested, there is little if any room for error (and thus creativity), because improving a patient’s health is the primary goal. In research, you have the time and freedom to explore how, why, and when different ideas/solutions work. Just as with art and literature, research is a way to entertain thoughts and play around with ideas.

There are most definitely drawbacks to a combined degree. My family has no clue what it is I’m doing, and every time I speak to them on the phone they ask me when I’m going to get married and have babies. EVERY TIME. I don’t speak for every Puerto Rican out there, but personally for me, the move to Philadelphia has been quite hard. Don’t get me wrong, Philadelphia is a really cool city with great people, food, and activities to do. If it weren’t such a great place to live and study, trust me when I say I would’ve been back to PR faster than you can say “mofongo relleno”. I miss my island and my family terribly- I miss the salty breeze, the heavy smell of mango in the high afternoon, and the trembling sun hot against bare skin.

One thing that I have found priceless for my transition has been to volunteer at Puentes de Salud, a clinic principally for uninsured Latinos, although really anyone needing medical assistance can attend. At Puentes, I have found a community of like-minded individuals with whom I learn side-by-side, and from whom I learn. The administrative staff is also very helpful and attentive, especially as you adjust to being a medical student.

I don’t think anyone would say medical school is easy- there is a lot of material to be learned and little time to do so. Nevertheless, when I am studying, I am often struck by the (very welcome) thought that I am really fascinated by what I study, and grateful that I am learning from true leaders in the field. Penn is an amazing school not because of what people think of it outside its walls, but by the amazing quality of those who work within it. I am blown away by the professors and researchers at Penn Med, and even more so by my peers. The diversity of people, talents, and viewpoints at Penn that makes it so that you can find people with whom you can both feel intellectually stimulated, as well as inspired.

Alejandra Guevara is a second year MSTP student. She attended the University of Puerto Rico Rio Piedras where she obtained a Bachelor’s Degree in Cellular Molecular Biology. She is involved in LMSA and Puentes de Salud. In her free time she enjoys eating, exercising, online shopping, and complaining about not having a warm, sunny beach near, not necessarily in that order.

Course Reps

It was wonderful meeting so many of you at Preview last week! We hope you all had a great time. We’ll be sharing a couple more posts this week. Whether you are already committed or still on the fence, we hope you find them helpful and interesting to read! 

From the very start of my medical school application cycle, I already had many compelling reasons to consider Penn as my top choice school. However, one of the features that really stood out to me from the interview day and Penn Preview was the degree of interaction I observed between students and the faculty and staff. Think back to your stops along the interview trail: at how many schools did you see students just freely pop in and out of the main administrative center, chat up the directors of academic programs and admissions and financial aid, and even pick up personal packages and a few Tootsie pops on the way out? (On that note, the new Suite 100 looks positively fabulous—as does just about everything else in our shiny new building.) These sorts of interactions capture the active dialogue between us students and the professors who teach us. It may sound cliché by now to hear students at different schools hyping up student evaluations, but that input really does matter and make a difference here at Penn Med as the faculty work to refine the curriculum from year to year.

This point is especially easy for me to appreciate as an MS1 Course Representative. Every week five of my classmates and I sit down for lunch with Dr. Goldfarb, the Associate Dean for Curriculum, the directors of the courses for the current block, and curriculum development staff, to relay feedback we have received from our classmates about the lectures and small groups for that week. We discuss during the meeting what could be done to resolve any significant issues and to improve the course for next year’s class. Just as medicine is an ever dynamically changing field, medical education remains a progressive effort. In this effort, Penn Med administrators clearly value our role in relaying feedback from students.

I have definitely appreciated the respect and attention that our professors have shown us during our meetings and their receptiveness to our feedback. The smaller improvements we suggest often are implemented immediately, while more expansive suggestions get incorporated into planning for the coming year (that means your class stands to benefit hopefully!) One director even took the time to meet with me for two hours one-on-one so that we could discuss suggestions I had developed and collected from classmates on how to improve his course for next year. This level of commitment isn’t just unique to him though; many course directors regularly organize focus groups to examine our feedback and online student evaluations and incorporate suggestions into the planning for the following year. It has truly been a gratifying experience, not only to work closely with our professors who are such interesting individuals, but also to serve as a liaison for our class to make sure our voices get heard and make an impact in our year and beyond.

All this said, with our accelerated preclinical curriculum having been implemented for well over a decade now, there really isn’t all that much left we can complain about as Course Reps. But which medical student would say no to a free lunch every week?

Lawrence is an MS1 at Penn who hails from Irvine, California, and graduated from Princeton University in 2014 with a degree in Chemical and Biological Engineering. He has keen interests in health policy, particularly with respect to healthcare access and disparities, and the psychology of giving and burnout with the medical field, as well as a current inclination toward pediatric oncology. In his free time, he enjoys going to the gym, watching movies, reading, and playing way too much table tennis in the student lounge.

Caring for the Underserved: Penn Med and Beyond

In honor of Match Day, we are publishing pieces written by MS4s. On Monday, we published a piece on Penn Med’s awesome student body. Today, MS4 Kenji Taylor shares how he explored his interests in primary care and family medicine for the underserved, at Penn Med and beyond.

“Dumela Ra!” (Good day, sir)

The young man greeted us politely yet anxiously, with the characteristic roll of the ‘R’ that we had been practicing for the past four weeks in Botswana. He had traveled two hours to see the specialist doctors from the United States because he was concerned about his heart. With the Botswana doctor and a medical student from Germany, we examined the patient and reviewed his EKG.  Assured by the physical exam and other data we had, we suggested that he come back in the next two weeks to provide continuity in care and make sure he was well. As he thanked us, my attention turned to the hot room overflowing with children, men and women of all ages who had been waiting patiently since the early morning to be seen by the primary care specialists.

I am living a dream: providing full spectrum primary care to underserved communities.

20150311_130745

Through the Botswana-UPenn program, I am spending seven weeks in several different hospitals, both in urban and rural settings, practicing inpatient and outpatient medicine with local clinicians, Penn residents and faculty. Already almost four weeks in, I’ve learned so much about diseases endemic to the region like TB and HIV, adjusted to relying purely on a history and physical exam when other tests aren’t readily available, gained an appreciation of Botswana customs around health, and developed a better understanding of the system of primary care.

I credit my time at Penn Med as the reason I was able to develop my interests in the specialty of Family Medicine and practicing medicine with undeserved communities both in the US and abroad. During my first three years of medical school, I helped build The Cut Hypertension Program with fellow classmates. This program sends students of all health professions into African American barbershops in our West Philadelphia neighborhoods to provide blood pressure screenings. Ultimately, the program aims to reduce the stark disparity of cardiovascular disease that African American men face. I’m proud to say The Cut Hypertension Program continues to flourish in Philadelphia, and most recently in Atlanta, with the help of grants from the Schweitzer Foundation and United Health Foundation.

Faculty mentorship from across the University in Family Medicine, Nursing, the Center for Public Health Initiatives, Wharton, General Internal Medicine and the Center for Behavioral Economics has been immense. It is a real strength of the medical school program that cannot be understated. With support and encouragement from faculty, I decided to take a year out from medical school and accepted a paid fellowship position with the Centers for Disease Control in the global maternal-child HIV group. It was during this year I augmented the excellent clinical training we receive as Penn students with the perspective of public health. I kept in touch with faculty mentors throughout my time with the CDC in order to help me keep my experiences in the context of patient care and help me transition back into my final year.

The strengths of medical education at Penn extend far beyond a second-to-none curriculum and training facilities. The exposure, leadership opportunities and faculty mentorship are phenomenal. I often did not fully appreciate these things until I left the University and realized how lucky we were to have so many resources and opportunities at our fingertips. Regardless of what your interests are in medicine, you can find the mentorship and guidance you need to help you realize those dreams.

Kenji Taylor is an MS4 from small towns in rural Kansas and Pennsylvania. He graduated from Brown University in 2008 where he majored in Neuroscience and East Asian Studies. He then worked for a couple of years in finance in LA, London and Tokyo before coming back to medicine. Outside of class, Kenji enjoys hiking, fitness, cooking and watching Hulu with his girlfriend.

LEAPP: 2 years later

In our previous post, MS1 Chris Corbett shared his experience so far with the LEAPP program. Today, MS3 Sarah Huepenbecker shares how LEAPP impacted her medical education over the last two years.

When I first met my LEAPP patient, Ms. M, I knew I was going to have an enjoyable experience. She was easily the most gregarious patient in the dialysis unit, and greeted my LEAPP partner and I with a huge smile and hugs. Her outfit and accessories were completely color-coordinated (a recurrent theme), and her blonde curls swung jauntily (a non-recurrent theme, as each subsequent visit introduced a new wig).

She launched right into her life story, telling us all about her career as “the dancing barmaid,” her two trouble-making sons, and her new fiancé. It took us a while to steer her towards telling us about her chronic disease: end-stage renal disease secondary to hypertension and diabetes.

In some ways, she had remarkably good insight and knowledge about her disease process—she could explain why she needed a low-salt diet, how the dialysis machines purified her blood three times a week, and the specific symptoms of uremia (a term I only vaguely understood at the time). I was struck by how upbeat Ms. M was about her diagnosis and prognosis—she enjoyed seeing her friends at dialysis three times a week, loved her nephrologist, and had lots of plans for her future.

This initial impression was a lasting one, and I always looked forward to my sessions with Ms. M. As my LEAPP partner and I met with her more often, we were able to get to know Ms. M as a vibrant person instead of just as a patient. By learning about Ms. M’s life outside of her disease, I was able to appreciate how various psychosocial, emotional, religious, and financial variables factored into her health.

For example, a few months after our initial meeting, Ms. M moved into a new apartment, which was both more affordable, allowing her to spend more money on fresh foods and maintain a renal-friendly diet, and closer to the bus stop, allowing her to travel to and from dialysis more easily. On the other hand, when Ms. M’s brother died unexpectedly midway through our LEAPP experience, she was deeply shaken and skipped several dialysis sessions and doctor’s appointments, which ultimately led to a few ER visits. During our year and a half with Ms. M, she went to the ER 5 times and was hospitalized twice (once for a clot in her dialysis fistula, once for a leg wound infection). It was a humbling experience, as a budding medical student, to see the progression of end-stage renal disease up close and personal. The bigger lesson, however, was seeing how the disease impacted Ms. M’s life and hearing her perspective on her own health.

Ultimately, my LEAPP experience gave me valuable insights that I will carry with me throughout my career. I had the privilege of getting to know a patient who was alternatively incredible, smart, energetic, non-compliant, scared, hopeful, and frustrating. I was able to see my patient as an utterly and beautifully human person with a life outside of her disease, and I hope to never forget that lesson as a physician.

Sarah Huepenbecker is an MS3 who is interested in OB/GYN and General Surgery. She is originally from Minnesota and completed her undergraduate degree at Penn in 2012, majoring in Biology and minoring in Hispanic Studies. In her free time she enjoys running, reading, good happy hours, and guilty pleasure TV.