1) How valuable is the Pre-Med program in preparing you for the MD 1 program at MUA? 

The Pre-med program was a valuable experience for me as it really prepared me for what's to come in the medical program.  I initially had applied for the medical program at first, but with my undergraduate degree, I was missing several core credits that would’ve required me a min. of a year to complete. The pre-med program is an intensive 8 month (or 2 semesters) program that allows you to complete all required courses within that time frame and successfully apply for the medical program. The faculty in the pre-med program analyzes the lectures they provide in the MD1 class and teaches you exactly what you need to know in order to prepare you for the future semester. The materials taught in premed have helped me in classes for the first two semesters of the basic science program. 

It was also a great way to familiarize yourself with the island life as well as forming new study habits and getting used to going back to school (for those who have been out of school for a while).

2) Please tell us a bit about how the MUA Mentors program at MUA works? Did you have a mentor when you came to MUA and were they helpful?

The MUA mentors program is a way for new students to get in contact with an upper med student who has already spent a semester on the island. The program is run by students and they normally try to assign you to a mentor who comes from a similar background (in terms of undergrad, city, etc) All incoming students are assigned a mentor and their contact information so by the time you start your new journey at MUA, you’ve already made a friend/advisor/mentor who can provide you with information and advice as someone who has gone through the same experience.  The program 

I had a mentor assigned to me a week before arriving on the island; the mentor had the same educational background (BScN) as me and we came from the same country (Canada) so it was extremely helpful when I asked her about course materials in comparison to what we’ve been taught before (in undergrad), and asking about processes in financial aid, banking, etc. 

3) How did you get chosen to be a TA, and what is that like?

The TAs are available to students for the Med program; The TAs are comprised of students from MED2-MED5. Students are chosen to be a TA by the course director at the end of the semester; the requirements are generally students who have received an A in the course, or have done extremely well throughout the semester and excelled in the course shelf exam. Normally a max. of 4 students are chosen per course. TA sessions occur once a week and it allows the students to come for an hour or two to review the past week’s material with the TA. For students who are either afraid to speak to their professor or haven’t had the chance to speak to them during office hours, or who just needed clarification in class materials will come to these sessions and I provide them with either material to help them understand better or hold review sessions to cover high-yield materials before exams. The students are also encouraged to e-mail us TAs if they require more help than what was provided in the session. 

Being a TA has allowed me to feel more comfortable with public speaking as well as a review of previous class materials so it has helped me maintain my knowledge more than what I would’ve retained without becoming a TA. Since not everybody gets chosen to become a TA it’s meaningful when your professors trust that you can teach the course material to the new students and validates the hard work you’ve put in during the semester. Time management skills are needed because you are taking several hours out of your week to prepare for your TA sessions as well as teaching it; for some students, they decline to be TAs due to the time constraints. 

For pre-med students there are no TAs; the school has a student-run tutoring program where students from both premed and the med program can request for a private tutor in their respective courses. 

*( Private tutors are based on a min. GPA for that course. i’m not a tutor so I can’t speak on the requirements to be a tutor; however I’ve been told tutors must need a 3.0grade in that course to tutor other students)

4) What is your “typical day” like at MUA?

My typical weekday involves waking up at 7 and get ready to head over to school where the days start at 8 and normally ends around 3 or 4 pm. From 8-12 we cover materials from physiology/ pharmacology/ pathology, have lunch for an hour and then have a 2 hour class on Clinical skills. Once I get home, I try to take an hour off to myself and then review the day's material. There are no visits to the beach (despite the stereotype of a Caribbean life) but I do try and go out for a run or walk around my neighborhood to clear my head. 

Newly minted doctors take the Hippocratic Oath pledging to “do no harm,” but what if the harm they cause results not from the failure to correctly apply what they learned in medical school but from racially-based ideas they learned there, or from racial stereotypes formed long before they ever started their studies?

These and other questions about how race factors into the delivery of healthcare were the focus of a recent opinion piece in The New York Times.

Racial categories—such Negroid, Caucasoid or Mongoloid—have a long history both in academic use and popular discourse. In Biology, the article in the Times notes, race is roughly analogous to the idea of subspecies. And there is no shortage of examples of how race has been used in medicine, often with negative results:

•  Sickle cell anemia was labeled a “black” disease, but in fact it afflicts many people who would be considered “white.”
• African-Americans are widely considered to be more susceptible to kidney disease. But in fact, not all African-Americans carry the gene variants that cause kidney problems.
• And there is a substantial body of research indicating that blacks and other minorities are less likely than whites to receive treatment for pain.
• Pointing to these and other examples, many argue that the concept of race in healthcare should be discarded, saying it is too unwieldy, too imprecise and has too much baggage to be useful anymore.  And it can lead to bad medicine, such as failure to do the appropriate screening for sickle cell among white populations. Or incorrectly discarding kidneys provided to donor programs by African-Americans. Instead, critics say it’s time to focus on the genes important to whatever medical puzzle is being addressed — an approach often called “precision” or “personalized” medicine.

But others say that’s not practical and point to cases such as

Prostate cancer: African-Americans have a higher risk than whites and the test for it, which looks at prostate-specific antigen, is known to yield many false positives. In this instance, though race might be a crude marker, some argue it’s still a usable one for determining how care should be provided.

Hypertension: African-Americans suffer from high blood pressure more often than whites do. Yet Africans in Africa don’t generally have high blood pressure leading to suggestions that experiencing racism is what’s raising blood pressure.

This brief summary just scratches of this debate and how it affects how medicine is both taught and administered. Read the full piece from The New York Times here.

Medical University of the Americas holds its annual Research Day on Saturday Feb. 10, 2018. Twelve students/faculty so far have submitted abstracts outlining their research. Meanwhile, the Research Day committee has shared the agenda: Poster session presentation, followed by oral presentations, and concluding with the awards ceremony for “Best Posters” and “Best Presentations.” Research topics range from speech pathology to wound and tissue repair. Should be a fascinating day and we will be sure to share the winners, and their posters. Stay tuned!

A recent article on Standardized Patient (SP) programs on the Association of American Medical Colleges website—Standardized Patients Teach Skills and Empathy—notes  that SPs are now “an integral component of our medical education system” playing a role both in the training of medical students and in licensure: the clinical skills component of the USMLE involves seeing a series of SPs over several hours. Read the full article here.

While beginning medical students once gained their first clinical experiences by practicing on their fellow classmates now leading medical schools, including MUA, have established formal SP programs in which individuals recruited from the local community are trained to act as real patients, simulating a set of symptoms or problems. Ask a student at Medical University of the Americas about the most memorable experiences of their first semesters and many will point to the classes involving SPs.

The SP program at MUA takes place in the school’s clinical training facility. It typically starts with students standing at the door of an examination room and reading a brief case report identifying the SP’s name, age, gender and chief complaint and listing a set of specific tasks that must be completed, such as establishing rapport and gathering a medical history. Then, on cue, the student heads inside.

Everything about the experience is “standardized”—the SPs are specifically training to present the same symptoms to each student and the students must complete their assigned tasks within a set period of time. The sessions are captured on video. Afterwards, students write up a note detailing the visit, which is carefully scrutinized by MUA faculty. The SPs also complete an evaluation of each student.

It is important learning for MUA medical students, and will be part of the clinical skills testing that they will undertake later in their medical school training.

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For decades, medical education consisted of two years in the classroom (i.e., learning the basic sciences) and two years making rounds (i.e., your clinical clerkships.)

But now leading medical schools, including Medical University of the Americas, have overhauled their curriculums to better integrate the clinical side much earlier.

There are many reasons for this change, but one often overlooked aspect is the realization that making such a stark transition from classroom to clinicals in the third year wasn’t healthy for anyone—not the students themselves and not their patients.

According to Danielle Ofri, a medical school professor and author of the book What Doctors Feel: How Emotions Affect the Practice of Medicine, the “ice-water plunge” into primal clinical experiences produces a welter of emotions, not all of them positive. Coming to grips with the messy realities of disease and death, observing egos and medical hierarchies, witnessing fear, anger, grief, humiliation in patients and doctors alike—and going through all of this for six-weeks, before being whisked off to start over again in other rotation—these are all reasons why the third year is often referred to as the “darkest” year of med school.

Ofri points to studies that document the decline of empathy and moral reasoning in medical trainees during the third year—emotions that can profoundly affect what kind of doctors these students become and the quality of medical care they can give to their patients.

On a positive note, she points to the growing recognition of this challenge as schools such as MUA reorient their clinical curriculums, introducing greater clinical exposure well before the third year and implementing more hands-on mentorship.

For more about Dr. Ofri’s observations, see her article The Darkest Year of Medical School.

For more about MUA’s clinical program, including interviews with deans and students, go to http://www.mua.edu/curriculum/clinical-medicine

 To become a practicing physician in the U.S., you must pass the USMLE. That’s true whether you attend a school located in the U.S. or an international school such as MUA. Here are some tips from Brian Radvansky, a USMLE Tutor, on mistakes to avoid while studying for USMLE Step 1 & 2 CK:

·       On test day, you will need to be focused and present for about 8 straight hours.  Start building that stamina now. Avoid giving yourself those “mini-rewards” for just completing a question block. Keep going.

·        Avoid doing too great a proportion of your practice blocks in Timed Tutor mode and getting overly used to expecting a green check or red X after every question. That obviously won’t happen on the exam.

·         Try as much as possible to physically emulate the actual test conditions, i.e., working at a desk vs. lounging with your iPad on the couch.

For nearly 20 years, an organization known as the Center for Health Workforce Studies (CHWS) has been compiling a “demand index” of medical specialties.

Each year, the CHWS surveys residents and fellows in New York State, inquiring about things like the number of offers received by respondents, trends in starting income and the percentage of respondents having difficulty finding a satisfactory practice position. When the CHWS first began measuring demand, family medicine was close to the bottom of the list. Since 2008, however, family medicine has seen increasing demand. And in 2015, it ranked at the very top.

Because about 15 percent of all residents and fellows in the US (including graduates of Medical University of the Americas) do their training in New York State, the rise in demand for family doctors there is seen as an indicator of the growing importance of family medicine.

Overall, the survey found that demand for generalists—family medicine, emergency medicine, adult, psychiatry, dermatology, and general internal medicine—appeared very strong. Efforts to reform healthcare delivery, such as the Affordable Care Act, are seen as likely factors in the changing demand index.

See the Health Affairs Blog for a summary of the report, co-authored by one of the original designers of the demand index. And you can read the full report here.

Should doctors be seen as skilled workers, adhering to rigidly proscribed protocols, or as medical professionals constantly called upon to exercise independent judgement?

Critics say that slavish adherence to medical protocols and evidence-based procedures are introducing an era of “cook book medicine.”  Others say that the protocols are right far more often than they are wrong and that giving doctors the kind of latitude that they enjoyed in years past is not good medicine.

Here at Medical University of the Americas, we focus on questions like these throughout our curriculum. Our students wrestle with these issues in the clinical training modules that begin in their first semester, in classes on medical ethics, and in the research program on medical literature all MUA students are required to complete by the end of their fifth semester. Learn more about MUA’s curriculum.

There is no single answer to this question and it is likely our students will be searching for the correct middle ground throughout their careers. While today’s protocols are in many cases based on extensive clinical research, no protocol can be right 100% of the time. And the history of medicine is filled with examples of practitioners who challenged the prevailing wisdom/protocols and were proved right.

For interesting discussions of these questions see Doctors are more than just skilled workers. Here’s why. And "Protocols are for nurses."

 At Medical University of the Americas, like many other medical schools, first semester students are presented with a short white coat symbolizing your status as a medical student. It’s a rite of passage and upon being awarded your MD from MUA, you will replace that short white coat with a long one that you will wear throughout your career as a physician.

But it turns out that you won’t be the only one wearing a long white coat. You might well be joined by a nurse, a physical therapist and others.  To an anonymous, young, female physician blogging on KevinMD, this is troubling: “It seems unfair that as someone who worked exceedingly hard for many, many years to earn the right to wear a long white coat, this ability is simply granted to other practitioners without any significance.”

 She notes that it is a particular problem for female physicians: “I often will enter a room and introduce myself as Dr. (last name), and I cannot tell you how many times the patient or family member will remark to another person in the room or on the phone, and say “Oh, the nurse is here.”

This physician isn’t casting aspersions at non-physician colleagues—simply wondering if there isn’t a way that other medical practitioners can acquire a distinctive, professional attire, symbolizing the dedication and skill they bring to healthcare, without it being the long white coat traditionally worn by physicians.

For Shivam Joshi, MD, the issue is not who wears the white coats, but where. Writing in his blog AFTERNOONROUNDS, he is troubled when he runs into fellow physicians wearing their white coats outside a clinical setting, i.e.,  buying groceries.

The Society for Healthcare Epidemiology in America (SHEA) recently recommended that healthcare providers should possess two or more white coats, launder them regularly and have access to hooks where the white coat (or other long-sleeved outerwear) could be placed prior to patient contact.

So, that first-semester White Coat ceremony? Yes it was a rite of passage–in more ways than you might ever have imagined.

How much has medical education changed over the years? Quite a bit: everything from the courses that a first-year med student takes to the hours that a medical resident spends on call has undergone an overhaul.

As What Medical Schools Are Doing Now That They Weren’t 20 Years Ago notes, today’s med students study anatomy and pharmacology, but they also take courses in medical ethics. They learn how to interpret symptoms, but they also learn how to crunch the numbers and evaluate the biostatics needed to support evidence-based medicine. And in addition to being required to assimilate vast quantities of information, today’s med students are also evaluated on how well they convey that information to the patient, aka their bedside manner.  All of that is a big difference from what medical school was like in the past.

Finally, a physician trained years ago might be surprised by the workload of today’s medical resident: Instead of being on call almost around the clock, regulations now limit a resident’s weekly workload to 80 hours.

The world of medical treatments never stands still—and the same is true for going to medical school.

For the first time in over a century, medical school curriculum’s are undergoing a major overhaul. A wide range of medical schools, including Medical University of the Americas, have changed their learning strategies to better prepare students for a medical world that is more patient-centered and focused on achieving measureable outcomes.

According to Dr. James Bruzik, Associate Dean for Medical Education who spearheaded the curriculum update at MUA, the new approaches are taking place on several levels:                                                                

Organ, systems-based approach: At MUA, basic sciences and clinical studies are now being taught in an integrated, organ-systems-based approach. That means (for example) when you’re learning about a developmental abnormality in a specific organ you also study the anatomy, genetic background and pharmacological approaches to treating it—all in one, integrated learning module.

Early exposure to clinical experiences: Students are exposed to clinical experiences from the very start. In your first weeks of classes at MUA, you may be learning about the basics of a particular medical condition and then attending a class where you’re doing role-play exercises or taking an oral assessment on how well you’re able to communicate with patients and medical colleagues about that condition.

Active learning: There is a great emphasis on active learning and classroom interaction. MUA has “flipped classrooms” designed for small group interactive learning and also incorporates much more in terms of ongoing formative assessment: in an ungraded format, students get the opportunity to take tests and see where they stand. 

Research: Because so much of medical practice today requires the ability to evaluate medical literature and advise patients on the latest developments, students at MUA complete a research project involving an in-depth review of medical literature on a specific topic. For many students, this research has become a key asset in getting selected for a top residency.

Medical education is changing. As a leader in international medical education, MUA is committed to being at the forefront of these changes. Learn more about the MUA curriculum, including an interview with MUA administrators and deans, at http://www.mua.edu/curriculum