UGA PREMED A MAGAZINE FOR STUDENTS INTERESTED IN SCIENCE AND HEALTH GRADY COLLEGE OF JOURNALISM
HEALTHCARE REFORM
DOCTOR DEFICIENCY
RELIGION AND MEDICINE
FIND US ON SOCIAL MEDIA WWW. PREMEDMAG.ORG
@UGAPREMEDMAG @UGAPREMEDMAG
2
PERSONAL HEALTH
@ PREMEDMAG @UGAPREMEDMAG
Table of Contents 4 7 8 9 10 12 13 14 16 18
Leara Scholarship A Message from Our Editor Senior Spotlight Student Organization Spotlight: Atlantis Fellowship Soon, Your Doctor Will Be a Click Away Doctor Deficiency Artificial Wombs: Fiction turned Future Where Are We with Health Care Reform? and‌ Where Are We Going? The Merger of Allopathic (MD) and Osteopathic (DO) Residencies Religion and Medicine: Friends or Foes? Science Compassion Vigilance
Dr. Pallavi Patel College of Health Care Sciences - Anesthesiologist Assistant Programs
http://healthsciences.nova.edu/healthsciences/anesthesia/
www.premedmag.org
LEARA SCH
ENTER FOR A CHAN
Premed Magazine is proud to offer you, our readers, a scholarship in each issue. You may submit an original piece of writing that represents your personal connection to our magazine. In each issue, the theme for the upcoming competition will be announced.
This issue’s topic: Write about what you think is the most issue in healthcare today as well as a well-researched solution. Submissions should be at least 500 words in length and include at least 3 expert primary sources. 4
PERSONAL HEALTH
HOLARSHIP
ANCE TO WIN $500
To enter, please submit an email to ugamedmag@gmail.com by August 3rd, 2018 with the following informaiton: -Your name -Your email address -Your phone number -Your local address -Your expected graduation date -Your major -Your current GPA Please attach your submission as .docx, .pdf, or .jpg. Remember, this scholarship is open to ALL MAJORS, not just pre-health students. The recipient of the scholarship will be announced in our next issue and will be rewarded with $500 to be used on furthering his or her education.
www.premedmag.org
5
STAFF FACULTY ADVISOR Dr. Leara Rhodes EDITORIAL BOARD Emma Burke Anson Dao Grant Mercer Sherry Luo COPY EDITORS Annika Jonker Christina Najjar Muhammad Siddiq Emma Burke
EMMA BURKE
EDITOR IN CHIEF
GRANT MERCER
COMMUNICATIONS EDITOR
WRITERS Emma Burke Neil Jacob Sherry Luo Katie Luquire Muhammad Siddiq Eric Santana Hallie Smith Skyler Tuholski DESIGNERS Sherry Luo PHOTOS Ushna Syed
ANSON DAO
TREASURER
SHERRY LUO
DESIGN EDITOR
INTERESTED IN JOINING OUR STAFF? APPLY ONLINE AT WWW.PREMEDMAG.ORG/APPLY/ WE ARE CURRENTLY LOOKING FOR TALENTED DESIGNERS, PHOTOGRAPHERS, AND WRITERS
6
PERSONAL HEALTH
A MESSAGE
FROM OUR EDITOR
In the short time humans have lived on Earth,
amazing four years over again. No matter where our
we have learned an incredible amount about ourselves
education takes us, we are all lifelong learners. That is
and how to increase the quality and quantity of our
the beauty of working in science and healthcare - while
lives. While today we take for granted how much we
we might earn numerous degrees, we never truly leave
know about human anatomy, the study only began
the classroom.
3,600 years ago in ancient Egypt. It wasn’t until
almost 1,000 years later that anatomists identified the
University of Georgia, I am excited for what the future
distinction between arteries and veins. Around this
holds for PreMed Magazine. My time with this brilliant
time, the Hippocratic Oath was created to set ethical
and inspiring group of students has not been nearly
standards for caregivers. Flash forward to today and
long enough. However, I am thrilled to announce the
consider where we would be without these seemingly
new leaders of this publication. Katie Luquire will be
basic discoveries. Now, imagine telling Hippocrates or
the new Editor in Chief, Muhammad Siddiq will be
Leonardo Da Vinci that we no longer have to cut our
serving as Campus Outreach, and Neil Jacob is the
patients open to see what lurks inside - all it takes is a
new Treasurer. I am also excited that Sherry Luo will
trip down to the radiology department. It is important
be continuing on as Design Editor and Grant Mercer
for us as future healthcare providers to always be
will be returning as Communications Editor. I cannot
respectful of what we understand and have yet to
wait to see where you all take PreMed Magazine, I look
discover.
forward to seeing how you each leave your mark on
your fellow pre-health students. To our readers - thank
Much like we can reflect on how far science
As I look forward to graduating from the
and medicine have come in the last 6,000 years, we can
you all for your support over the last year. We create
also see how much we as students have grown over the
this magazine for you and we are thankful to be part of
course of the school year. Some of us began in August
your journey at the University of Georgia. We, the staff
as freshmen - excited and fearful of the unknown.
of PreMed Magazine, cannot wait to see how each of
Others are seniors, with similar emotions to their
you impact the future of medicine.
first-year counterparts, wishing they could start these
www.premedmag.org
7
SENIOR SPOTLIGHT Annika Jonker
This spring, Annika will be graduating with a triple major in avian biology, biology, and art history. She has loved discussing current events with other staff members, staying up-to-date on pertinent medical issues, and learn what other PreMed Mag contributors were interested in. After two and a half years as a staff member and Copy Editor, she is looking forward to taking a gap year before applying to medical school with the goal of becoming a pediatrician. Born in South Africa, Annika speaks four languages fluently. We are very excited to see where Annika goes next and will miss her dedication to the magazine!
Christina Najjar
Christina will be graduating in May with a double major in biochemistry and molecular biology. Her favorite part of being a member of PreMed Magazine for the past four years has been “the creative outlet the magazine has provided amongst predominately hard science courses.” After graduation, she will be getting married and attending medical school. In her free time, Christina likes to oil paint. We will certainly miss Christina’s contributions as both a writer and Copy Editor next year and wish her luck with her future schooling!
Emma Burke
Emma will be graduating in May with a degree in genetics and biology. She is thrilled to be attending the Medical College of Georgia beginning in the fall. In her three and a half years with PreMed Magazine, she has served as a writer and Editor in Chief. Her favorite part of working with the magazine has been forming mentor-type relationships with other successful pre-health students. Emma ran her first half marathon in October and is looking forward to completing a marathon before graduating from medical school. We are thankful for Emma’s service to the magazine and wish her the best!
Hallie Smith
Hallie will earn her degree in journalism this spring. As a biology minor, she will be applying to medical school this upcoming summer. She is hoping to work as an entertainment staff member at Disney World during her gap year. In Hallie’s two years with PreMed Magazine, she loved being able to write articles that she could use to express her ideas free from the constraints of class-required writing assignments. Not only is she a UGA Majorette, Hallie is also an accredited parliamentarian. We cannot wait to follow Hallie’s journey to become a physician and wish her the best of luck!
8
PERSONAL HEALTH
STUDENT ORGANIZATION SPOTLIGHT
ATLANTIS FELLOWSHIP BY SKYLER TUHOLSKI
I could not imagine a better way to accumulate those critical, yet hard-to-find, shadowing hours than through a total cultural immersion shadowing program like Atlantis. Atlantis is a student-founded organization that hosts 20+ hour/week AAMC compliant shadowing experiences in Europe and Latin America. In addition to fostering medical education by offering weekly rotations through chosen specialities, each fellowship includes an exciting weekly excursion, 3 group meals, travel health insurance, and housing. After my 4 week fellowship in a small town in Spain, I left with unforgettable experiences both in the hospital and in exploring Spain with people that would become lasting friends. I shadowed in the specialties of pulmonology, OBGYN, general surgery, and nephrology while learning how tax-funded public healthcare and culture shape healthcare delivery. I stood next to a surgeon throughout a 4-hour laparoscopic colectomy, witnessed the birth of a beautiful baby girl, and learned in-depth about dialysis and how it impacts patients’ lives. I also went kayaking and swimming in a pristine lake, took a day trip and historical tour of Toledo, and visited our city’s wine museum to learn about wine tasting and the history behind the region’s greatest export. During our free time on the weekends, my group chose to travel to Madrid, Seville, and Valencia together by train and had so much fun exploring together. I highly recommend Atlantis fellowships to anyone interested in shadowing physicians and traveling! With locations in 10 different countries, the option to add MCAT prep courses, and summer 2018 programs that vary between 3 and 8 weeks, this experience is completely customizable and worthwhile! Please contact me at stuholski@uga. edu for exclusive application access and program insight!
www.premedmag.org
9
Soon, Your Doctor Will Be a Click Away by Katie Luquire
If you’ve ever been to an emergency room for a
had spread. If there had been a way for her to see a
minor injury or ailment, you’ve likely waited hours on
doctor without taking a sick day, maybe Edna would
end for treatment. You also probably paid a large sum
have had a better outcome (Brawley and Goldberg,
of money for your treatment. Unfortunately, this is the
2011). One-fifth of Americans live in rural communities,
result of a healthcare system that relies on visits to the
where primary care is scarce and the only option for
emergency room, especially for low-income populations
treatment is costly emergency facilities (Freudenheim,
who may not be able to see a primary care physician
2010). However, telemedicine provides a solution to the
for a problem that grows increasingly worse. The novel
barriers to treatment that plague our current system by
How We Do Harm shines a light on individuals like Edna
generating an ongoing dialogue between patient and
Riggs, a fifty-three-year-old woman who has symptoms
provider.
of breast cancer. However, because her employer would
not let her take sick days, she didn’t see a doctor until
telehealth has emerged. This advance in medical
her breast had fallen off due to her tumor and her cancer
technology is defined as the use of electronic
10
PERSONAL HEALTH
In the advent of increases in technology,
communication to exchange
Much of the focus of
cover telehealth the same as in-
medical information and deliver
telehealth is being directed towards
person services. However, states
remote healthcare (Loustaunau,
rural areas where primary care is
vary greatly in their coverage for
2013). Telehealth may be used
scarce. For example, telemedicine
Medicaid, and Medicare covers some
in many aspects of medicine
has also allowed providers of
services but not others. Additionally,
and covers a broad range of
emergency medicine to share ideas
because telemedicine is a new
treatments. For example, telehealth
due to the ease of communication
concept, there may not be adequate
includes online communication,
between rural doctors and trauma
technology to diagnose a patient.
appointments with a healthcare
specialists in big cities. In fact,
This disconnect might lead to lower
provider, and even includes online
teletrauma technology is projected
satisfaction by doctor and patient,
support groups. One of the most
to connect every hospital with
and even worse health outcomes.
popular forms of telehealth is two-
trauma facilities in the future
way communication between doctor
and has already saved many lives
improves, care will become more
and patient, where the patient
(Loustaunau, 2013). Victoria Corbett,
accessible and the patient-doctor
describes his/her symptoms and the
a nursing student who is studying
relationship might even change for
doctor determines the best course of
at the University of North Georgia
the better. Through telemedicine,
treatment. Telemedicine allows you
is optimistic about the future of
patients who are not currently able
to see a doctor wherever you choose,
telehealth. “It’s really cool,” she says.
to receive care will have better
and you are able to choose a doctor
“I think it will be used to help a lot
access to treatment, which will
regardless of your location. Many
of medically underserved areas
lead to better health outcomes for
illnesses, like respiratory illnesses
connect with doctors”. Victoria
the nation as a whole. While doctor
and urinary tract infections, often
also mentioned that she has seen
visits are currently an occasional
require a simple specimen sample
telehealth in action in the ICU at
experience, telemedicine could
for diagnosis. An at-home test and a
Emory. According to their website,
change the way we view medicine
quick video chat allows a patient to
Emory’s Johns Creek location has
and even transform doctor-patient
quickly receive the medication that
partnered with AcuteCare to help
interactions into an ongoing
they need without spending hours in
stroke patients gain timely access to
conversation.
an office.
specialty neurological consultations
via telemedicine in order to avoid
Telehealth has the potential
Although, as technology
to change how we view medicine
the debilitating effects of stroke
and to break down some of the
that occur due to late diagnosis
barriers that prevent patients from
(AcuteCare, 2014).
seeing their healthcare provider. An
article in the New York Times tells
electronic stethoscope and video
the story of Charlie Martin, a crane
conferencing, patients are able to
operator who complained of sharp
receive care no matter their location.
pains in his lower back. While most
However, while telehealth is gaining
of us would jump in the car and visit
traction, it is not without drawbacks.
a local doctor, Charlie was working
While many insurance companies
Brawley, O. W., & Goldberg, P. (2012). How We Do Harm: A Doctor Breaks Ranks About Being Sick in America. New York: St. Martins Press.
on an oil rig in Malaysia. Through
are starting to cover telemedicine, it
two-way video and an electronic
is not as universally covered as face-
FAQs: About Telemedicine. Retrieved from http://www.americantelemed.org/about/telehealth-faqs-
stethoscope, an emergency
to-face appointments. According
medicine physician was able to
to the American Telemedicine
remotely diagnose Charlie with a
Association, thirty-four states
kidney stone (Freudenheim, 2010).
require that private insurers
Through technology like the
AcuteCare Telemedicine Expanding Services at Emory Johns Creek Hospital. (2014, June 13). Retrieved from http://www. acutecaretelemed.com/press-releases/ACT_EmoryJohns.pdf
Freudenheim, M. (2010, May 29). The Doctor Will See You Now. Please Log On. The New York Times, p. BU1. Loustaunau, M. P. (2013). Telemedicine. Magill’s Medical Guide (Online Edition). Xu, R. (2014). The Doctor Will See You Onscreen. Retrieved from https://www.newyorker.com/ business/currency/the-doctor-will-see-you-onscreen
www.premedmag.org
11
Doctor Deficiency
meet patient demand (Dayaratna, 2017). The
on the country’s physician workforce
factor affecting all specialties and having the
(Marcus, 2017). Advancements in technology
largest effect on physician supply will be the
are another factor that could play a role
retirement rate of current practicing doctors.
in solving the crisis. Remote technologies
In the next 10 years, more than one-third of
such as telemedicine, which is the use of
all the current active physicians will be 65 or
telecommunications to remote diagnose
older (Mann, 2017).
and treat patients, could reduce the need
for as many specialists. Many fields such as
by Muhammad Siddiq
point to a major shortage that is only
dermatology are already using this service
growing, it is important to understand that
(Marcus, 2017).
the shortage is much more complicated than
reports suggest. There are many other factors
the future, it is difficult to predict how
that need to be taken into consideration
short the nation will be of physicians. The
and several suggestions have already been
physician shortage crisis is troubling to think
proposed to avert the crisis. For one thing,
about and there is certainly not one easy
much of the shortage lies in the hands of
solution to the problem, but if technology
government regulation. The Association
advances fast enough, the government lets
of American Medical Colleges is actively
in foreign doctors and chooses to increase
advocating for increased federal support
funding for physician training the increasing
for additional residency positions. Without
need for medical professionals can be
this support for medical graduate education
alleviated.
Health care debate seems to
constantly dominate headlines. Many Americans, however, are unaware of a major issue affecting the United States’ healthcare system. The United States is facing a significant shortage of physicians and evidence suggests that the recent deficiency of medical professionals is only going to get worse.
The United States’ physician
shortage is being fueled many factors including population growth, an increase in the number of aging Americans, and the retirement of practicing doctors (Mann, 2017). A recent study done by the Association of American Medical Colleges estimates that the United States will be in a deficit of anywhere between 40,800 and 104,900 physicians by the year 2030. The study found that primary care physicians and other medical specialists are currently unable to keep pace with demands of the growing and aging population. These demands are significant as projections suggest that the total U.S. population is expected to grow 12% by 2030. Similarly, the number of U.S. residents aged 65 and older is expected to increase 55% by that time (Mann, 2017). AAMC President Darell G. Kirch, MD. explains, “This makes the projected shortage especially troubling, since as patients get older they need two to three times as many services, mostly in specialty care, which is where the shortages are particularly severe” (Mann, 2017).
As Kirch suggests, speciality care
faces the greatest demand as the projected shortage by 2030 is expected to be between 33,500 and 61,800 physicians compared to primary care’s projection of between 8,700 and 43,100 physicians (Mann, 2017). There are a number of factors that contribute to this, but it can be suggested that this is due to residency match system not producing appropriate distribution of doctors to
While all evidence and projections
With so much uncertainty regarding
it will be difficult to increase the number of active practicing physicians (Mann, 2017). Furthermore, it will be important to see how immigration policy over the next few years affects the number of foreign physicians able to enter the country. How welcoming the U.S. is to international medical graduates will have a huge impact
Dayaratna, K., & Singh, S. (2017, May 31). Solving the Physician Shortage Crisis. Retrieved April 02, 2018, from https://www. dailysignal.com/2017/05/31/solving-the-crisis-of-physicianshortages/ Mann, S. (2017, March 14). Research Shows Shortage of More than 100,000 Doctors by 2030. Retrieved April 02, 2018, from https://news.aamc.org/medical-education/article/new-aamcresearch-reaffirms-looming-physician-shor/ Marcus, M. B. (2017, March 20). New report predicts “troubling” shortage of doctors in the U.S. Retrieved April 02, 2018, from https://www.cbsnews.com/news/doctor-shortageus-impact-on-health/
A
r
b
t
h
c
l
e
w
d
s
a
o
f
s
t
w
c
w
a
b
a
e
p
H
a
l
e
m
w
T
12
PERSONAL HEALTH
Artificial Wombs: Fiction Turned Future by Sherry Luo
that is filled with amniotic fluid. Attached
have made it very clear that this device, if
recreated parts and functions of the human
to the bag and the lamb’s umbilical cord
approved for human testing, will not be used
body. Limb prosthetics have been used
is a machine that functions as a placenta.
on infants prior to 23 weeks as they are too
throughout history. Pacemakers help our
This “biobag” is meant to recreate all the
delicate and negative outcomes are more
hearts beat regularly. Mechanical ventilators
conditions a fetus would experience inside
likely to occur. There is no guarantee of
can move air into and out of our lungs. The
a mother’s womb. The scientists at the head
success that this device will work on human
list of medical innovations and inventions is
of this study have even gone so far as to
babies, and it could potentially cause a great
endless. These artificial means apply to those
keep the lamb fetuses in a dark, warm room
deal of stress and discomfort for them when a
who have exited the womb, but what about
and play sounds of a mother’s heartbeat for
peaceful death may be preferable. Scientists
devices for premature babies?
them. Videos of these lambs in their artificial
are concerned about what this device will
wombs are available online. The eight lambs
mean for the blurry line between fetus and
states that approximately 15 million babies
in this study spent a month inside these
baby, a point of serious contention in abortion
are born prematurely every year, a million
bags before the researchers euthanized
debates, and whether or not this kind of
of who die of complications that stem
them to study the developmental effects
technology might bring our society a step
from preterm birth. Ninety percent of them
of being inside the bag. The researchers
closer to a science-fiction universe, one that
survive with severe complications. One of
developed a particular fondness for one
is not far off from Gattaca or Aldous Huxley’s
the main problems is that preemies are born
of the lambs and donated it to a farm after
oft-cited Brave New World. Artificial wombs
with underdeveloped lungs and brains. The
it was healthily “born.” The researchers
also have multiple implications in issues
chances of survival for babies born at 26
emphasize that the purpose of this study,
such as maternity leave and abortion.
weeks are fifty percent; any earlier than that
however, was not to study long-term survival
and their chances drop significantly. Preterm
but fetal development. While this is not the
lives of many premature babies to come, but
birth rates are increasing in every country,
first time an artificial womb has been created
the future of this technology is unclear as it
and while postnatal treatment and therapy
or tested, this is the first time it has been
affects not only the babies, but also parents,
exist, there are no current methods for
this successful; previously, in a very similar
ethics committees, and physician decision-
prenatal treatment.
Japanese study in 1996, researchers ran into
making.
circulatory problems.
Over the years, we have artificially
The World Health Organization
In 2017, scientists at the Children’s
Hospital of Philadelphia successfully created
an “artificial womb.” They used premature
hopes to test this device on extremely
lamb fetuses that were developmentally
premature babies (born between 23 and
equivalent to 23-week-old fetuses as their
26 weeks) within three to five years. This
models. With this device, the lamb fetuses
artificial womb has the potential to decrease
were able to develop normally for a month.
preterm death rates, but this may not be
The fetal lamb is inside a clear, plastic bag
an ethically sound method. Researchers
Artificial wombs could save the
The group in charge of this study Swetlitz, I. (2017, April 26). Artificial womb keeps premature lambs alive for weeks. Are humans next? Retrieved April 07, 2018, from https://www.pbs.org/newshour/health/artificialwomb-keeps-premature-lambs-alive-weeks-humans-next Stein, R. (2017, April 25). Scientists Create Artificial Womb That Could Help Prematurely Born Babies. Retrieved April 07, 2018, from https://www.npr.org/sections/healthshots/2017/04/25/525044286/scientists-create-artificialwomb-that-could-help-prematurely-born-babies
www.premedmag.org
13
Where Are We with Health Care Reform? and… Where Are We Going? by Hallie Smith 14
PERSONAL HEALTH
Uncertain. Three failed attempts to replace the Affordable Care Act are the marker of 2017 for the Trump administration, yet the debate is not over. No issue has faced as dubious a future as the topic of healthcare. In the fall of 2016, Jonathan Gruber, Ford Professor of Economics at Massachusetts Institute of Technology, said it best, “Obamacare is not going away. There may be a few changes around the edges.” Obamacare has given health insurance a solid foundation that will take time to build upon as medicine and the economy advances, he added. Gruber predicted correctly as there have been a few changes made that will affect the way healthcare is administered in the United States. Let’s take a look: · The enrollment period for federally run exchanges was shortened. · Enrollment assistance and advertising were cut substantially. · Payments to insurance companies to help with cost-sharing subsidy enrollees were discontinued. · Rules were issued to roll back a federal requirement for coverage of birth control to be in employers’ health insurance plans. · The mandate that citizens are required to buy insurance was eliminated. These adjustments will definitely affect the way that states regulate insurance. They must work to cooperate within the bounds set by federal mandates, but also provide affordable plans and benefits while providing access to essential services. The biggest threat to the stability of health care is the elimination of insurance requirements of all US. citizens. Economists predict that the absence
of the mandate with rekindle the insurance death spiral that we experienced in 2010 when only 53 percent of the American population had employer health insurance plans. This threat has sent policymakers back to the drawing board. Among the many options is the single-payer system variation. Many other countries use this system in which health-related costs would drop dramatically. Marketing and administrative expenses for the current health care system are much more than they would be under the single-payer system. Additionally, almost all practices, examinations and medications cost substantially more in the U.S. than any other country. In recent years support for the single-payer system has risen and a June 2017 poll demonstrated that 60 percent of Americans agreed that the federal government should provide universal coverage. Even though millions of Americans are in support of universal coverage, millions still would mount up against any change in their current health coverage. Employer coverage hides the paycheck sacrifice while the single-payer system would be covered by taxes. This fact leads many to prefer the current system and shun any changes. Economically, the single-payer system barely changes the tax burden we presently have; however, the phrase “increasing taxes” tends to put a sour taste in almost all Americans’ mouths. A recent proposal by the Center for American Progress entitled, “Medicare Extra for All,” is a universal system that would be available to all Americans and employ an out-of-pocket limit for expenses. This plan could be employer sponsored and would not replace private insurance entirely. Medicare Part E, or Medicare for Everyone, is another idea formed
by Jacob Hacker, a Yale political scientist. His plan would allow anyone, no matter what age, to buy into Medicare. As ideas are tossed about in the vast array of political debates, the White House budget proposal for fiscal year 2019 dictates that Medicare and Medicaid spending should be cut by 5 percent. This is predicted to save more than $490 billion within 10 years by cutting Medicare hospital payments, nursing home compensation, and funding for teaching hospitals. It hopes to reduce out-of-pocket drug costs for Medicare recipients by requiring that insurance agencies and pharmacies share in the payment. Since the biggest responsibility for health care falls on the states, legislators are working to develop plans that could meet their own state’s needs while upholding the national mandates. Medicaid is of utmost importance, and Section 115 waivers are allowing states to waive certain requirements for distinct necessities. Many are working to shift care toward wellness and preventative services while attempting to lower drug costs through rebates and purchasing agreements. From the provider perspective, Dr. Thomas Caven said, “Keeping people healthy is a civic duty.” As Vice President of Medical Affairs and Medical Director at Dell Seton Medical Center at The University of Texas and University Medical Center Brackenridge, Caven has watched the climate change fairly drastically since he has been practicing medicine. “Healthcare is expensive. We’ve still got to debate if healthcare is a right – that everyone should have it; but some people still adopt the view that healthcare is a privilege,” he said.
www.premedmag.org
15
e
p
b
u
o
a
s
i
The Merger of Allopathic (MD) and Osteopathic (DO) Residencies by Eric Santana
s
a
o
A
c
c
i
y
s
t
o
h
DOCTORS TO-GO? by Eric Santana
a
T
a
(
s
m
t
h
i
s
a
e
w
d
a
m
t
I
t
p
o
A
i
16
PERSONAL HEALTH
Today, there are two options in terms of
meet the standards of the merger and accreditation
education for undergraduates who want to be a
system, it will be shut down. This would leave students
practicing physician in the United States. The first and
without a residency for the time being.
better-known option is to attend an accredited medical
university that will gain the status of Allopathic Doctor
merger it seems that it will be a positive change for the
or Medical doctor (MD). The second option is to attend
healthcare field as it will diversify the background of
an accredited medical university that will give one the
future physicians, while also creating a standard for the
status of Osteopathic Doctor (DO). These two options
quality of education received by students in residencies
in terms of what type of program to enroll in are very
around the United States. However, this transition will
similar and essentially achieve the same goal, the
prove to be very difficult as some students will be left
ability to practice medicine. The main differences are
in closing programs without anywhere to turn and the
often in areas of focus as well as the official license.
question of whether or not a true criterion will be able
Additionally, the residency programs students could
to be adequately and fairly set is still something that
choose from were also different. DO schools were often
is in discussion. How will the transition to this new
criticized due to their seemingly inferior programs; that
system bring new challenges to today’s current medical
is now changing.
students? Only time will tell.
After better understanding the nature of the
By the time the class of 2020, currently second
year medical students, apply for their residencies, students from DO and MD schools will both apply to same programs. A merger between the two organizations, the ACGME (MD) and the AOA (DO), that head the residences is occurring in order to promote a more respected and uniform standard of medicine. This merger will consequentially form one standard
Alexander, Grant. “MD DO MERGER 2020 (BAD FOR DO?).” Student Doctor Network, 9 Sept. 2016, forums.studentdoctor.net/threads/md-do-merger-2020bad-for-do.1220951/. Ella, Mary. “Residency Merger- The Impact on Current Med Students” Merck Manual Med Student Stories, Merck Sharp & Dohme Corp., 16 Nov. 2016, medstudentstories.merckmanuals.com/residency-merger-the-impact-oncurrent-med-students/. “Single GME: Student Questions Answered.” American Osteopathic Association, American Osteopathic Association., 2016, www.osteopathic.org/inside-aoa/ single-gme-accreditation-system/Pages/single-gme-student-faqs.aspx.
and shall be known as the General Medical Education (GME) Accreditation System. By establishing one standard, the process of applying to residencies will be made easier on DO students attempting to gain entry to MD residencies. Before the merger occurred, they had to take an additional test in order to gain entrance into these rigorous program. Furthermore, creating one standard residency program for medical students will also increase the quality of education, as the scholastic expectations will be raised within many programs that were less challenging before. The GME also hopes to diversify medicine with this merger and appreciate and interpret the various aspects that the two forms of medicine highlight.
Providing excellence and leadership in education, patient care and research Palmer College of Chiropractic provides a challenging, yet supportive academic environment that prepares you for one of the fastest-growing health care careers.
Despite the positive aspects of this merger, the
transition will also prove to be a very difficult process. In particular, students are concerned this may make the residency applications much more challenging, particularly for DO students who previously had the option to exclusively participate in DO residencies. Another problem students may face is that if they enroll in a program before the merger occurs and it does not
www.palmer.edu
Campuses in Davenport, Iowa, Port Orange, Fla., and San Jose, Calif.
The Trusted Leader in Chiropractic Education®
www.premedmag.org
17
Religion and Medicine: Friends or Foes? by Neil Jacob
According to the most recent reports on Americans and Religion in 2017, about 80% of Americans identify themselves as having an affiliation to religion (Newport, 2017). Most of these Americans will go on to teach their children about religion to ensure that they build a faith of their own. When children start to grow up, they go to school on weekdays to build on their education and to prepare for their respective future career. Interestingly enough, religion can be found in elementary schools all the way to high school. During this time, children recite the Pledge of Allegiance, they chant four words: “One nation under God�.
18
PERSONAL HEALTH
Then, in high school biology, topics such as the Big Bang theory and evolution are thoroughly discussed, leaving students confused whether or not religion is fantasy or reality. After these children are accepted into college, many professors make it clear that they know that religion is indeed fiction. In fact, the number of college students with no affiliation to a religion has tripled over 30 years (Downey, 2017) and that Atheism is the most practiced religion amongst college professors (Amarasingam, 2011). With a vast majority of Americans practicing religion at a young age, why is it that the trend of religion seems to take a drastic turn when students get
older and how does in any way does this affect the medical field today? To answer this question, the history of our distant ancestors must be explained. One of the earliest known civilizations that emerged from the typical hunter-gatherer groups of humans was named Mesopotamia. With the abundance of fertile land that surrounded the civilization, the Mesopotamians were able to advance technologically and intellectually at exponential speeds. New methods of agriculture that were formed was a big part of how civilization advanced but one of the most interesting advancements that arose was the formation of
organized religion. Not only was religion formed, but it was also combined with medicine to create a new, unique treatment for its citizens. The Mesopotamians used supernaturalistic treatment methods along with natural treatments such as twigs, plants and leaves to heal other sicknesses that arose within the civilization (Koenig, 2000). This created the pathway for other civilizations to form healthcare after Mesopotamia had disappeared and became the primary form of healthcare for thousands of years to follow. With evidence linking religion and medicine coexisting for tens of thousands of years, it is interesting that religion is completely underutilized in the medical field today. A recent test was held at Harvard Medical School to determine the influence religion has in the medical school curriculum and the impact religion has on doctor and patient relationships. According to the results, one key point to note was that religion was rarely discussed in the medical school curriculum and did not have a role in medical student socialization training. More interestingly, when the students that had indicated that they had no religious affiliation were asked about helping an emotional patient, they were less inclined to properly aid the patient than a medical student that indicated any religious affiliation. The experiment also showed the effect of no religious affiliation in other training challenges such as loss of compassion for patients and a worse work-life balance than religious students. Coping is an important mechanism that practicing physicians need to properly choose to treat patients and to keep a healthy state of mind for the physician. Wrong forms of
coping can lead to consequences that can harm both the practicing physician and the patient. When the coping mechanisms of non religious students were analyzed, the most utilized mechanisms among these students were repression and compartmentalization, which are both categorized as harmful forms of coping, while prayer and faith were common coping mechanisms that are unique to religious students that shows no negative side effects for the patient or the physician (Balboni et al., 2015). With all of these trends showing a more positive patient physician relationship with religiously affiliated students, it is hard to understand why this topic is rarely discussed in medical school. It is evident that medicine and religion have both been important implemented together in the most advanced ancient civilizations and have been proven to positively affect medical students and patients. Even practicing physicians have attested to the fact that religion is a great help to medicine. David Madder, a professor at Johns Hopkins University has discussed how his faith has encouraged him to view all people equally and has encouraged treatment of his patients. He states that his faith allows him to go the extra mile when it comes to dire situations and it helps him go above and beyond for each of his patients (Karani, 2017). Although the number of students with religious affiliation drops after college, it is evident that physicians and students that have any sort of religious affiliation creates better work ethic and better results, which is why religion should have a more pronounced role in the medical curriculum. This does not mean that students with no religious affiliation are worse physicians in any way, but it is important
that religiously affiliated students recognize the misconception that medicine and religion do not go together. As Albert Einstein once said, “Science without religion is lame. Religion without science is blind.” My spin on this quote is that Albert Einstein was trying to say was that one cannot go without the other. To say one is right and the other is blatantly wrong is a grandiose misinterpretation that can be dangerous without knowledge on both. The two go hand in hand and with more utilization in the medical field, religion and healthcare can once again have a profound impact.
Amarasingam, Amarnath. “Are American College Professors Religious?” The Huffington Post, TheHuffingtonPost.com, 6 Oct. 2010, www.huffingtonpost.com/ amarnath-amarasingam/how-religious-areamerica_b_749630.html. Balboni, Michael J., et al. “Religion, Spirituality, and the Hidden Curriculum: Medical Student and Faculty Reflections.” Journal of Pain and Symptom Management, U.S. National Library of Medicine, 27 May 2015, www.ncbi.nlm.nih.gov/pmc/articles/ PMC5267318/. Downey, Allen. “College Freshmen Are Less Religious Than Ever.” Scientific American Blog Network, Scientific American, 25 May 2017, blogs.scientificamerican.com/ observations/college-freshmen-are-lessreligious-than-ever/. Gallup, Inc. “2017 Update on Americans and Religion.” Gallup.com, 22 Dec. 2017, news. gallup.com/poll/224642/2017-updateamericans-religion.aspx. Karani, Rabia. “Christianity and Modern Medicine.” Biomedical Odyssey, 10 Mar. 2017, biomedicalodyssey.blogs.hopkinsmedicine. org/2017/03/christianity-and-modernmedicine/. Koenig, Harold. “RELIGION AND MEDICINE I: HISTORICAL BACKGROUND AND REASONS FOR SEPARAT
www.premedmag.org
19
\ - William J. Mayo
“The aim of medicine is to prevent disease and prolong life, the ideal of medicine is to eliminate the need of a physician.�