As a  teaching assistant in histology, neurology and microbiology at MUA, a volunteer at the Centre for Animal Rehabilitation on Nevis, Premier of Nevis Award recipient, and a Clinical Dean Award recipient,  Christopher Smith made every moment count while at Medical University of the Americas. Thrilled to come to MUA in January 2014, he noted, "I was waiting tables and bartending before MUA gave me the opportunity to fulfill my lifelong dream and attend medical school". He was grateful for the newfound sense of purpose that the school gave him. "Coming to MUA provided me with a new foundation of hope for myself and my future. Apart from my own intrinsic drive, watching dedicated classmates around me working so hard also really helped motivate me to want to be the best I could be. It truly had a hugely positive effect on me."

"The professors were always available, and really knew what they were teaching really well. I was frequently probing them for more information, and I eventually fell in love with the learning process. My Neuroscience teachers, in particular, were willing to talk with me for hours on end, and I began to learn of my passion for neurology in these long engaging conversations and lectures. My clinical work was spent mostly at a teaching hospital in Louisiana and it is one of the best programs for training. The learning style is incredible: each day you are in there learning through your hands as well as through didactics."

"Working with MUA, I got the opportunity to do a Neurology elective rotation at LSU in New Orleans in my 4th year. I really loved working with the residents, staff, and enjoyed the overall environment. Where you choose to do your electives is critically important. I recommend to students that they work on getting an elective rotation at the program that they want to match into. This was where I wanted to match, and I did." Christopher is thinking about a possible fellowships in one of two areas of neurology, either Neurophysiology or Neurocritical Care (such as working with patients with life-threatening neurologic injuries/conditions).

Working in downtown New Orleans has been an added bonus for this bilingual doctor fluent in both French and English.

Arber Frakulli is a third year med student at Medical University of the Americas, who has been blogging about his medical experience along the way. He calls his blog “Arber Frakulli @MUA”. Click here to see his beautiful photos taken while doing his Basic Sciences on the island of Nevis.

https://arberfrakullimed.wordpress.com/pictures-from-nevis

Click here to read his research paper (his RLRA) entitled “Correlation between the temperature of e-cigarette coils and the levels of carbonyl toxicant formation due to the thermal decomposition of propylene glycol and glycerol solvents found in e-liquids”

https://arberfrakullimed.wordpress.com/research

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.

For a vivid picture of the diverse world of healthcare today, read the recently published opinion piece in The New York Times by famed NBC newscaster Tom Brokaw.

For years one of the most prominent journalists in America as the anchor of the NBC Nightly News, Brokaw described today’s typical, big city hospital as “a universe of scientific genius and selfless compassion populated by what seems to be the most diverse population in the country.”

Brokaw, who calls himself an “active pilgrim” in the medical world (having sought treatment for cancer, kidney stones carrier and other ailments) reflected on his experiences with spinal surgeons of Russian origin, Ecuadorean eye specialists, Chinese imaging experts, Kazakh physical therapists, East Indian oncologists and an orthopedist from Bologna with whom he traded New York Italian restaurant recommendations.

And the diversity extends beyond big cities. The piece also looks at the challenges of rural hospitals and how these communities benefit from physicians of varying backgrounds—including “homegrown physicians” who came to medicine with unique perspectives.

Read the entire piece here.

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.