The Podcast by KevinMD

"As medical trainees, we will shape the rapidly changing health care environment in this country. We are fiercely advocating for our disadvantaged patients, debating the price of life-saving medications, and carefully considering how the upcoming elections will shape the health care system in which we both provide and receive care. All the while, we handle our responsibilities and prepare to care for critically ill patients during a seemingly inevitable pandemic. These diverse issues bring to light a huge deficit in medical education — the lack of training on complex health systems." Daniel Arteaga is an internal medicine resident. Isobel Rosenthal is a psychiatry resident. Lauren Tronick is a medical student. They are founders of the podcast, Well Rounded. (https://podcasts.apple.com/podcast/well-rounded/id1498401733) They share their story and discuss Daniel and Isobel's KevinMD article, "Medical trainees need knowledge and education on health care systems and policy." (https://www.kevinmd.com/blog/2020/03/medical-trainees-need-knowledge-and-education-on-health-care-systems-and-policy.html)

Thank you for listening to the podcast. There were some audio difficulties during this interview, which I hope you can overlook. It certainly does not take away from Dr. Syed's message and her wonderful interview. "An essential part of daily living for many people is faith. No matter what faith you belong to, people practice their faith in different ways. Most people have faith intertwined with their daily routine in some form or another. Whether a person prays at that start of their day in solitude or in congregation, faith is a fundamental part of life for many people. There are so many challenges with how to observe their faiths and traditions in these unusual times. Most religious organizations have not been congregating in parts of the country with a large burden of COVID cases. Some faiths have shifted to virtual congregations. People are accustomed to praying and feasting with their loved ones. Although the human connection is being displaced in these times, and a shift is being placed on a virtual connection with the aid of technology, the gain that is resulted from the sacrifice is tremendous. With every social distancing encounter and sheltering in place, action comes the reward of a life saved. Uzma Syed is an infectious disease physician. She shares her story and discusses her KevinMD article, "During the pandemic, faith keeps us together." (https://www.kevinmd.com/blog/2020/04/during-the-pandemic-faith-keeps-us-together.html)

"In my lifetime, I have encountered those who have seemingly endured far greater states of human privation than I could ever imagine (though I try to eschew establishing comparative equivalencies [or non-equivalencies] among human suffering as much as possible because such an impossibly herculean task never ends well). And what I have come to realize is that the nexus of all of these extraordinary stories of tragic afflictions being overcome was the individual's remarkable propensity for gratitude and their mental aptitude to reorient, reframe, and reappraise all that was bad … into all that is good. Unlike biological antibodies that fight microbial marauders just by our very nature of existing until the illness passes, the acquisition of emotional antibodies is a far less passive process. We have to be proactive in our efforts to construct and build meaning around the negative impact of the trials around us, and integrate all that we ascertain into the person that we are … and the person that we become—our identity." Jay Wong is a medical student at the University of Michigan Medical School. He received his undergraduate degree in molecular, cellular, and developmental biology from Yale University. He can be reached at his self-titled site, Jay Wong, and on Twitter @JayWongMedicine, Instagram @JayWongMedicine, and Facebook. He shares his story and discusses his KevinMD article, "A vaccine alone will not be enough to recover from the impact of COVID-19: Emotional antibodies against it are needed as well." (https://www.kevinmd.com/blog/2020/05/a-vaccine-alone-will-not-be-enough-to-recover-from-the-impact-of-covid-19-emotional-antibodies-against-it-are-needed-as-well.html)

"Empathy is more than just loving an elderly loved one. It is more than simply making the decision we may feel is best for our loved one. Empathy is different from sympathy. Empathy means putting ourselves in someone else's shoes and making an informed decision. Empathy is seeing through our loved ones' eyes, hearing through her ears, feeling her emotions, and thinking about her thoughts. It requires internalizing her feelings and acting accordingly. It is a crucial component when working with older adults." Mahesh Moolani is an internal medicine physician and author of Tough Decisions In Care Of Elderly Loved Ones (A guide for caregivers). (https://amzn.to/3ekRLtl) He shares his story and discusses his KevinMD article, "Empathy is a crucial component when working with older adults." (https://www.kevinmd.com/blog/2020/03/empathy-is-a-crucial-component-when-working-with-older-adults.html)

"When I first heard about medical schools fast-tracking graduation for students and shifting young residents into high need areas to fight the pandemic of COVID-19, I thought of how panicked those students and residents must feel. Asking them to step in to fight a battle we don't know how to win, and envisioning them witnessing the suffering and death of multiple people due to lack of resources and a broken system is terrifying. Asking them to risk their own safety and that of their families due to a paucity of protective equipment is beyond the pale. My more experienced colleagues whisper to each other that we too are afraid of serving on the front lines, but inevitably someone says, 'I guess this is what we signed up for.' The truth is none of us signed up for this." Deborah Edberg is a family physician. She shares her story and discusses her KevinMD articles, "Words of courage for medical students and residents" (https://www.kevinmd.com/blog/2020/03/words-of-courage-for-medical-students-and-residents.html) and "Stop calling health care workers heroes and do something to help them." (https://www.kevinmd.com/blog/2020/05/stop-calling-health-care-workers-heroes-and-do-something-to-help-them.html)

"The USMLE has failed the medical education community, and subsequently, future patients, as medical students will undoubtedly have irreplaceable damage from this experience; however, like all tests, it is possible to learn from mistakes and improve. In these unprecedented times, we as students understand the need to be flexible, but in return, we ask not to be forgotten and left abandoned by the USMLE. Let us work together, find solutions, and move onward." Colin Quinn is a medical student. He shares his story and discusses his KevinMD article, "How the USMLE fails COVID-19." (https://www.kevinmd.com/blog/2020/05/how-the-usmle-fails-covid-19.html)

"The COVID-19 pandemic has turned medical education upside-down. From exclusively virtual pre-clerkship courses, to delayed clerkships, to canceled graduation proceedings, there has been massive disruption. Now, after weeks of speculation, we've learned how the pandemic will be disrupting the 2020-2021 residency application cycle. The Association of American Medical Colleges (AAMC) is now recommending that all residency interviews be conducted virtually. While this a wise recommendation, out of concern for public safety, I fear it will exacerbate long-standing problems in the residency application process and will have dire consequences for many applicants." Jordan Hughes is an emergency medicine resident. He shares his story and discusses his KevinMD article, "To the AAMC: Recommend an interview limit or else this year's residency match may be a disaster." (https://www.kevinmd.com/blog/2020/05/to-the-aamc-recommend-an-interview-limit-or-else-this-years-residency-match-may-be-a-disaster.html)

"The reaction to the COVID-19 pandemic in the comprehensive psychiatric emergency program (CPEP) began insidiously, with an initial sense of unease. Patients are brought into CPEP when they pose a danger to themselves or others. Often they are brought by police, but occasionally they come on their own or with concerned family members. CPEP is a locked unit, separated via locked double doors that require a valid ID badge to pass. It is its own world, walled off from the rest of the hospital, and is a place where overwhelmed patients tell their stories and seek help." Ruchi Vikas is a psychiatry resident. She shares her story and discusses her KevinMD article, "Emergency psychiatry during COVID-19." (https://www.kevinmd.com/blog/2020/05/emergency-psychiatry-during-covid-19.html)

"Over a period of about two years, our city experienced a very large influx of seniors. One nearby town grew by over five thousand people. This, in turn, created a surge of patients coming to the hospital. As most were older, they often had multiple medical conditions. They would almost always require more complex care. The whole system became overloaded because, once again, no one had thought to make extra resources available. In the emergency department, this translated into a genuine crisis. Though the actual number of patients we saw in a day stayed about the same, what did change was the type of patients we were seeing. More patients came in that were not mobile. Thus, many required stretchers. Until this time, having patients in the hallway was a rarity. Now, it became the norm. Our normal workload in the monitored area had been three or four patients per nurse. Suddenly, it was not unusual to have six to eight patients per nurse." "T. C. Randall" is an emergency room nurse and author of The View From The Wrong Side Of The Day: A Story About Nursing, PTSD And Other Shenanigans. (https://amzn.to/2TDggtu) He shares his story and discusses his KevinMD article, "An emergency room nurse diagnosed with PTSD." (https://www.kevinmd.com/blog/2020/05/an-emergency-room-nurse-diagnosed-with-ptsd.html)

"As a physician anesthesiologist who has previously been on assignment for Doctors Without Borders in a resource-depleted region fraught with conflict, I'd like to say there's little I haven't seen. But now, after four weeks of staffing COVID intensive care units and emergency response teams throughout New York City, I struggle to distinguish between the exhaustion of a distant war-zone and the fatigue I see in state-of-the-art medical facilities. In some ways, my past experience treating war-wounded Syrian refugees mentally prepared me for my most recent journey where I dropped the comforts of life in California, booked a one-way ticket to the Big Apple, and secured emergency credentialing at multiple hospitals in the global epicenter of the virus outbreak. But in other ways, the campaign against COVID-19 is its own brand of horror, and I find myself worn down overseeing emergency intubations and debating the ethics of ventilator distribution, whether or not to initiate cardiopulmonary resuscitation, and how to help patients die with dignity when they are nearing end-of-life." Ajit Rai is an anesthesiologist and interventional pain physician and can be reached at his self-titled site, Ajit Rai MD. He shares his story and discusses his KevinMD articles, "Opening America: Should we really have to choose between economic revival and human life?" (https://www.kevinmd.com/blog/2020/05/opening-america-should-we-really-have-to-choose-between-economic-revival-and-human-life.html) and "Young physicians belong on the battlefront." (https://www.kevinmd.com/blog/2020/04/young-physicians-belong-on-the-battlefront.html)