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May 26, 2020

The Easy Elective—A Surprising Revelation in Medical School

Author Affiliations
  • 1Uniformed Services University F. Edward Hebert School of Medicine, Bethesda, Maryland
JAMA Intern Med. 2020;180(7):929-930. doi:10.1001/jamainternmed.2020.1330

Twelve medical students sit around an oval table crammed into a dark conference room with cinderblock walls. The table is scattered with poetry, paintings, and the remains of a potluck breakfast: some egg scramble and nearly empty coffee cups. Our hands are in various states of disarray: some neatly folded, others nervously tapping. Mine are tugging at the loose threads in my camouflage uniform. This is just another day in the course called Reflective Practice: Metacognition. It is supposed to be an easy class. The idea is simple: we read a few books from a curated list. Then, we must produce and share a creative piece that reflects how each book influenced us and what it says about our world views. Ultimately, the goal is to link our reflections with our professional identity and to continue our growth as future physicians. Thus far, I have shared a song and made a collage of old electrocardiography strips; others have baked biscuits, danced a hula, and performed original poetry.

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    11 Comments for this article
    lovely
    Patricia Fahy, MD | Fahy Consulting
    Wonderfully written. Thank you.
    CONFLICT OF INTEREST: None Reported
    Fifty Years Ago
    Michael Severson, MD |
    You have articulated this experience so well. I could have benefitted by this opportunity fifty years ago as a Vietnam veteran medical student. Some classmates knew but my experience was never solicited. If it had been, I suspect I would have been expected to apologize.
    CONFLICT OF INTEREST: None Reported
    Very Moving, Well Said.
    Melvin Gonzalez, M.D. FACC | Eisenhower Medical Center
    Back in the days those of us from the wrong side of the tracks kept our mouths shut because we were afraid that our unique experiences would upset the majority and maybe the school. Your experience shows progress is being made. Over a forty year career I found those unique factors allowed me to deal with diverse people from farmworkers to NFL owners. Mel Gonzalez M.D. Harvard 1979
    CONFLICT OF INTEREST: None Reported
    We are all in this together
    George Anstadt, MD | U of Rochester
    Building trust among peers is at the heart of Professionalism. This wisdom should become inculcated into the entire the medical school curriculum.
    CONFLICT OF INTEREST: None Reported
    Life Group
    Peter Wong, BSc MBBS MD FRCP FESC | Private Practitioner
    Meeting regularly in a small group can be called a fellowship or life group in a Christian circle, where individuals can find friends and discover more about life, not just as professional doctors.
    This is particularly relevant when we can meet online or face to face during times such as COVID-19 or going through personal trials.

    Thank you for your sharing.
    CONFLICT OF INTEREST: None Reported
    Easy Elective
    Richard Dart, MD | Marshfield Clinic Research Institute
    Thank you. This sort of thing was totally, and unfortunately, absent at the time of my medical school education. Wonderful article.
    CONFLICT OF INTEREST: None Reported
    Very much appreciated
    Alyn Caulk, MD, Family Physician | Dept of the Navy; outpatient clinic
    It would have been nice to have this opportunity 35 years ago when I was in medical school... or anytime thereafter. I felt isolated from all my physician colleagues never or rarely really getting to know them.
    Thank you for your article.
    CONFLICT OF INTEREST: None Reported
    Personal connections immunize against suicide
    Steven Reid, MD, FAANS | Doctor Lifeline
    Physician emotional isolation is a major contributor to the epidemic of doctor suicides. Most practicing doctors do not think they have the time to dedicate to "extraneous" socialization with their colleagues. However, sharing of personal experiences can go a long way to mitigate depression, burnout, and learned helplessness.

    Medical students take such courses because they have the time, and the opportunity.

    We need to restructure practice environments to give practicing physicians similar time and opportunities.

    Doing so can save lives.

    For more, please see www.doctorlifeline.org.
    CONFLICT OF INTEREST: I'm president of Doctor Lifeline, a nonprofit working to prevent physician suicides
    Thanks
    Mark Horton, MD MSPH | Public Health Institute, Oakland, CA
    Thanks for sharing and inspiring.
    CONFLICT OF INTEREST: None Reported
    Powerful
    David Simmons, BS, Physics MEd | Retired
    Second read. Second set of tears. I wish you well in your practice.
    CONFLICT OF INTEREST: None Reported
    Respite care for turbulent times
    Adelais Markaki, PhD, APRN-BC | University of Alabama at Birmingham, School of Nursing
    Thank you for a masterfully written piece.

    Resonates with experience from introducing a "Compassionate Care" course to first-year medical students in Greece and how an "easy" elective became a "transforming" elective. That experience, cultivated within US academic health centers at turbulent times as presently, holds great promise.

    Whether students, faculty or clinicians, we all need a safe place for a much needed break to reflect, re-charge, and re-connect with each other. Let's think of it as respite care for the mind and soul of healthcare providers.
    CONFLICT OF INTEREST: None Reported
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