Photo Credit: Ian G. Holyoak/Nevis Tourism Authority

CNN just came out with its list of the 18 Best Places to Visit in 2018 and Nevis is No. 5.

According to CNN “even people who think they've seen-one-seen-'em-all when it comes to Caribbean islands will look in awe at the quieter, simpler, more connected with nature way of life here.”

Noting that Nevis was spared hurricane damage last year, CNN warmed to the idea that Nevis’s “elegant white beaches may now experience a deserved uptick in tourists.”

See the whole article here.

Typical classroom scene at MUA

Medicine has historically been a male profession—for years most medical schools would not seriously consider women applicants. That’s been steadily changing since the 1970s and 2017 marks a landmark in the drive to gender parity: among this year’s beginning medical students, women outnumbered men for the first time.

According to the 2017 report on applicants, matriculants, and enrollment by the Association of American Medical Colleges, women made up 50.7% of incoming medical students compared with 49.8% in 2016. Viewed over two years, the number of women entering medical school rose by 9.6%.

Read more about the 2017 class of medical students 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.

Getting into medical school has always been a challenge. But there is growing data to suggest that it is more difficult than ever.

While class sizes at U.S. medical schools have grown in recent years—and new schools have opened—it has not been enough to keep pace with the increase in the number of applicants.

According to a recent US News and World Report (citing data from the Association of American Medical Colleges--AAMC) between 2006 and 2016, the number of applicants to U.S. medical schools increased by more than 35 percent, rising from 39,108 to 53,042.

The competition is particularly strong in primary care programs: the average number of applicants at the top 10 primary care programs more than doubled between 2006 and 2016: from 3,273 applicants for the class entering in 2006 to 7,175 applicants for the class entering in 2016. Because available seats did not grow by nearly that amount, the acceptance rate fell from 8.8 percent to 4.6 percent.

There are not only more people seeking to become physicians, each applicant is applying to more schools: the typical applicant in 2016-17 sent in 16 applications resulting in a whopping 830,016 submissions.

While the AAMC data is for U.S. schools, the situation in Canada is similar.

The increasingly intense competition for medical school seats at allopathic institutions is a key reason why a few select international schools such as Medical University of the Americas, which have secured the full set of US approvals and accreditations (and are approved to participate in U.S. Federal Student Aid program) are an attractive option.

On Saturday mornings, members of the MUA Black Students Association tutor students from the nearby St. James Primary School on Nevis. This Fall, the BSA took its involvement to a new level, organizing a drive for books and supplies for the five classroom school.

Nevis Television was on hand when Leaders of the BSA Gayane Balasanyan and Bobby Birhiray presented the materials to Kevin Barrett, Permanent Secretary of the Nevis Ministry of Education.

See the newscast—the segment on the BSA school drive starts at 2.40

https://www.facebook.com/nevistelevision/videos/2088365287844059/

Students in the Fall 2017 semester at MUA took a moment for the camera after the White Coat ceremony.

Canadian students have long been a vibrant and important part of MUA’s academic community. MUA also recognizes that a medical school education is a significant economic commitment. In support of this need, MUA is pleased to offer to qualifying candidates the Canadian Achievement Scholarship.

Starting with the January 2018 semester, Canadian applicants can apply for the scholarship which is worth up to US $12,500.

To learn more, contact the Scholarship Committee at scholarship@mua.edu
Additional details can be found at www.mua.edu/canadian-achievement-scholarship

Students at Medical University of the Americas were back in class this week as the campus quickly resumed full operations after Hurricane Irma. First year students enjoyed some of the beautiful sunshine after taking part in the traditional White Coat ceremony.

This semester, students at Medical University of the Americas (MUA) are making full use of the new clinical teaching facility.

Designed to match the feel of an examination room that you might find in a physician's office, a clinic, or an emergency room, this latest addition to the MUA campus on Nevis helps students become familiar with the actual context in which patient care takes place.

To support progressive development of the students' skills, critical thinking and decision making, clinical cases and simulated patients are used. A central demonstration area allows faculty to teach important aspects of patient interaction and treatment that students can then practice and develop in small groups at any of the 18 patient examination stations.

Students also benefit from the partial task trainers that allow them to focus on practicing specific clinical techniques.

On the long list of life’s great questions, deciding whether or not to attend medical school ranks well up there. Will you take the plunge or not? It’s a dilemma and we humans hate dilemmas. When we come to the fork in the road, we often simply turn around. We grab at seemingly credible reasons to not do something, when upon closer inspection those reasons really don’t add up.

The website PreMedStar recently identified five reasons that keep people from going to med school. Here they are along with our take on them:

1.       I am not smart enough. Well, what is “smart?” Is the person who is “smart” in mastering organic chemistry also “smart” when it comes to evaluating a patient with a complex medical condition? In terms of the classic view of being “smart”, e.g., getting good grades on academic work, PreMedStar notes that if you can successfully make it through college then you are capable of succeeding in medical school. If you don’t like academic work and do not want to put in the effort to do well, that’s another issue. But it has nothing to do with being “smart,” whatever that means.

2.       My scores aren’t good enough. Unfortunately, scores have a lot to do with getting into medical school.  Standardized tests such as the MCAT, once intended to create a level playing field and eliminate favoritism, have morphed into hard-and-fast admissions cut offs. Everyone agrees that there are plenty of students who do not do well on standardized tests who would make great doctors. So, don’t let a bad test score psych you out. It’s a hurdle to overcome, not an insurmountable barrier. Here at MUA, we have seen numerous students who impressed us in many ways beyond their MCAT and GPA, and have gone on to become very successful physicians.

3.       I can’t afford medical school. No question, medical school is a big investment.  Here at MUA, we are proud that our tuition is one of the most cost-effective of all the leading international medical schools (see a comparison here), but we still know the burden this places on our students and their families. Government loans are one way that many manage this—MUA is one of the few international schools eligible for the U.S. Federal Direct Student loans. (Learn more here.) And keep in mind that there are many repayment options through the military, federal programs, or practicing medicine in underserved areas. Doubts over finances tend to bleed into other doubts and amplify them. Don’t let that happen. What seems like a major financial undertaking today, may seem far less onerous once you have successfully done it.        

4.       Doctors work too hard. Yes, this is true.  So do medical students. In fact, so do most people who want to accomplish something valuable. And as PreMedStar notes, this is true for many other professions that offer less job satisfaction and pay much less.

5.       It’s too late. While the average age for entering medical students is 24, more and more students are entering medical school at later stages in their lives. Here at MUA we have seen outstanding success from students who have come to us after careers as teachers, engineers, paramedics and more.  Read about them at http://www.mua.edu/for-alumni/alumni-spotlight

As in all big, life-changing decisions, you are going to be wracked by doubts. It’s natural. But make sure those doubts are really based on something—before you allow them to destroy your dream.

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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.

Michael Collins is an orthopedic surgeon in a practice just outside of Chicago—he’s been doing the same thing, with the same practice, for more than 30 years. He’s also the author of two memoirs: Hot Lights, Cold Steel traces the arc of his four-year surgical residency at the Mayo Clinic, from eager but clueless first-year resident to accomplished chief resident. His second memoir, Blue Collar, Blue Scrubs, goes back further in time to his pre-medical school life working construction jobs.

Both books are great reads, as is a recent interview in which he reflected on his life and the changes he has seen in medicine. Some of the most interesting takeaways from the interview:

·     Back when Collins went to medical school at Loyola University (today the Loyola University Chicago Stritch School of Medicine), the curriculum was completed in three years. He says today’s four-year curriculum is better.

·     Collins matched in pediatrics before his first experience with orthopedics. He finished out the year in pediatrics and then switched to a four-year orthopedics residency.

·      In going for his residency, he didn’t do any visiting rotations. He got into the orthopedics residency because he played hockey with a guy who was high up in the department. He is staggered by what medical students today have to do to get a residency.

·        After practicing for over thirty years, how does he keep from burning out? “Burnout occurs when there is a disconnect between expectations and reality. It’s important to go into things with an understanding of what it’s going to be like. There are negatives: you probably won’t make as much money as a generation ago, plus the other things like paperwork, and the business of medicine. These are all true, and they are a problem. But I think if you focus as a clinical practitioner, basic things haven’t changed in thousands of years. You go into a room, talk to the patient, figure out the patient’s problem, and do whatever you can to help them. Helping people with their problems is the greatest thing about medicine. If you focus on that instead of the paperwork you have to do, you’re less likely to burn out.”

Collins has many more interesting observations. Ready them in the interview or take some time to read one of his memoirs.

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.

It’s the biggest fear of every pre-med student: doing everything you can to realize your dream of becoming a doctor, but being done in by a low GPA

Linda Abraham (@Accepted) a leading med school admissions consultant, tackles this issue head on in 4 Ways to Get Accepted With a Low GPA.

Abraham counsels students to focus on showing that you have overcome whatever flaws led to the low GPA in the first place e.g., you had a bad freshman year, but great grades since then) while also providing positive reasons for a school to be excited about accepting you now (your experiences in medical settings, volunteer work, research projects, etc.)

According to Sarah Russell, director of admissions at MUA, a GPA should never be looked at out of context. “We want your whole story, including what steps you have taken to address your GPA score. That tells us much more about you and it’s a proven way for us to identify the students who have what it takes to graduate.” For more about MUA’s admissions policies, go to www.mua.edu/admissions

Your clinical rotations are a critical part of your medical education. Now you are out of the classroom and into the hospital, learning directly from practicing physicians. As these are your final semesters in medical school, you are also making major decisions about your residency and what kind of medicine you will practice.

• At MUA, we focus our clinical program around the needs of our students, creating a “customized road to residency.” For a great video describing how the clinical program at MUA works, click here
• The MUA clinical program extends across nearly two-dozen medical centers located throughout the US. The size of our clinical program gives our students broad exposure to a wide range of medical conditions and also enables them to complete their clinicals in a timely way.
• Once your core rotations are completed, you can take elective rotations at virtually any medical center in the US and Canada. MUA students have completed electives at scores of institutions in nearly every medical specialty.

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.