Editorial

Alexandra Rabin

Clinicians from Different Eras Shine Their Lights on Medical Education

It is an immense privilege to be a student. few other situations afford us the chance to explore fundamental topics while also forming our views on the world around us. In the realm of medical education, we are particularly lucky, knowing that our training contributes not only to our personal fund of knowledge but also to supporting our mission of ameliorating the world around us. The world of medical education has evolved drastically since the era of the Ether Dome, shaped by shifting standards in healthcare and teaching and by new technologies. This edition of Worcester Medicine seeks to highlight the forces that have shaped our medical educational system from the eyes of those participating in the system’s evolution.

I had the opportunity to speak with five Worcester-area physicians whose time in medical school ranged from the 1950s to the 2010s. It is easy to imagine how much our educational system has changed since 1959, when our most senior colleague graduated medical school. I’ve witnessed how profoundly my own education has been impacted by the COVID-19 pandemic and was curious to hear how events like the Vietnam War shaped medical school experiences in the 1970s. I encourage younger readers to pay particular heed to the evolution in our clinical experiences. Dr. Lynn Eckhert, Class of 1970, writes about spinning her patients’ hematocrits and examining smears herself on overnight shifts. It’s fascinating to see how our responsibilities have shifted since then.

We are fortunate to hear from Dr. Michele Pugnaire, former senior associate dean for educational affairs at UMass Medical School, who expertly contextualizes the evolution in medical education since 1910. Dr. Pugnaire details the origins of the current “2x2 framework” of undergraduate medical education, paying particular attention to recent curricular reforms designed to promote healthcare quality, equity, and patient safety across all stages of learning. The future of medical education is bright, she notes, as innovations in curricula will serve to cultivate future generations of humanistic and quality-focused physicians.

Philip Feinberg and Dr. Silvia Corvera collaborate to highlight the distinctive skill set of physician scientists, particularly in the rapidly evolving world of COVID-19. Their article delivers an insight into the UMass Medical School MD/PhD program, which serves to train the next generation of research-oriented physicians. As the authors note, MD/ PhD students and faculty are integral to bridging the gap between the bench and the bedside. In fact, the MD/PhD program arranged campuswide physician scientist forums at the onset of the COVID-19 pandemic, helping to convey the findings of early basic science research on the virus to the UMass community.

The intricacies and objectives of nursing education are deftly summarized by Elizabeth Delsignore, MS, RN, and Michelle Paik Page, DNP, RN. The authors provide a well-referenced history of nursing education as early as 1872, as the need for formally trained nurses became apparent in the post-Civil War era. Since then, a number of avenues for nursing education have become available, including the associate degree of nursing (ADN) and bachelor of science in nursing (BSN). While the number of BSN-educated nurses has increased, the authors argue that augmenting the proportion of nurses with BSN degrees will encourage better healthcare outcomes.

Though medical and nursing school can be incredibly busy, many students set aside time for exciting research projects. I urge the reader to look at several innovative projects highlighted in this edition. To assess the effect of the COVID-19 pandemic on firearm-related violence, Julia Sherman and the Pediatric Surgery Research Group are examining factors associated with firearm-related hospital admissions and ED visits during the pandemic as compared to years prior. Zachary Michaels details his findings studying the association between chronic pain, mental illness, and suicidality in his patients. Jessica Ferreira, recent UMass nursing school graduate, initiated a program at Milford Regional Medical Center that enhanced nurse-led stroke screenings in the ED to hasten stroke detection. And Kevin Makhoul, always interested in history, describes his fascinating profile of Dr. Julia Gordon Arrowood, the first female anesthesia resident and department chief at Massachusetts General Hospital.

Dr. Kate Freeman, a third-year UMass Internal Medicine resident, offers an informative and personal insight into “the Match,” the process by which medical students secure spots in residency programs. Dr. Freeman depicts her own journey through medical school, interweaving information on the match process itself and the experiences of her peers. She shares her disappointment in matching to a residency program that would separate her geographically from her husband, a fear of many prospective residents understandably aspiring to their first-choice programs. Encouragingly, Dr. Freeman writes that she is now thriving, and would not have changed the outcome of her match. I encourage my peers, particularly other fourthyear medical students, to read Dr. Freeman’s story for a realistic and reassuring take on this daunting process.

A remarkable story about filial co-residents at St. Vincent Hospital, initially published in the Worcester Telegram & Gazette in 1992, highlights the unique challenges faced by a duo of international medical school graduates. Drs. Andino and Andy Abril hail originally from Colombia, where Andino trained in tropical diseases before immigrating to the United States. Andy, his son, joined his father at St. Vincent hospital for their Internal Medicine residencies. This article provides a captivating glance into a one-of-a-kind family, and I urge the reader to take a look.

And last, please take a look at our exciting snippets, curator and legal columns.

I would like to thank the Editorial Board of Worcester Medicine for the opportunity to act as Guest Editor for the September/October 2021 edition. I am incredibly lucky to have attended medical school in Worcester, where medical education is unquestionably in good hands.

Alexandra Rabin is a fourth-year medical student at UMass Medical School.