See One, Do One, Teach One

I have completed countless dissections in the anatomy lab and have observed even more through videos provided by Ross University. Like any diligent student I have studied anatomy by creating my own drawings, mnemonics, notecards, and through the ever popular rote memorization. This semester as an anatomy TA I have been given the opportunity to teach first semester students the anatomy of the human body from head to toe. As the phrase ‘see one, do one, teach one’ suggests, my medical learning experience will finally come full circle. I’ve made it this far- how hard can teaching really be?

An experience I had with three first semester students in the gross anatomy lab in the beginning of my second semester made me realize how rewarding teaching is. In no time, I ran through the anatomy of the upper limbs and superficial back with them and quickly quizzed them on the brachial plexus. Not only was I amazed at how much material I had retained but I recognized that I was still learning, compounding new and old information, and making even stronger connections this time around. I loved being able to integrate the 2nd semester anatomy of the pelvis with the 1st semester anatomy of the lower limb. Being able to take the material I memorize and integrate it with the material I actually understand.

My favorite part, however, was how innate my understanding of the arteries of the body felt. It was like driving through a familiar town I hadn’t visited in a while. For instance, last weekend I visited Binghamton. When I drove through the city I lived in during my undergrad years it felt as if I had never left. The map of the city is engrained in my head. Even after major road construction, I could still contemplate the deviations and possible detours I could take to shorten my journey. Likewise, the twisting and often times confusing pathways of arteries of the human body is now engrained in my head. My understanding has become second nature as to how the arteries of the head and upper limbs branch from the arch of the aorta before it becomes the abdominal aorta and continues down to give rise to major branches like the celiac trunk, superior mesenteric and inferior mesenteric arteries. How the splitting of the abdominal aorta gives rise to all the major arteries of the lower limb. These arteries are a roadmap to the human body and I don’t have to stop for directions.

Besides improving my own understanding of the body, it was rewarding to help others improve theirs. It always amazes me when I see the material a student in the semester above me is studying. The work always seems infinitely harder, more complex, and something that I’ll surely never be able to understand…at least until I start chipping away at it. I’ve come to find that the most challenging part of studying is similar to the most challenging part of running- the first step. It’s easy to become overwhelmed with the vast quantity of material I need to cover or how far I plan to run. It’s what makes studying for a final exam that much more daunting. But by simply taking that first step, studying becomes a smoother and less stressful experience. And that’s what the best TAs did for me. They gave me a gentle push in the right direction. A spark to ignite my engines. Momentum to overcome inertia.

However, the best TAs weren’t always the smartest ones. Well, maybe they were. I never really stopped to survey them about their grades. The best TAs would always exhibit the same qualities that my favorite middle and high school teachers and undergraduate and medical school professors have exhibited over the years. They were able to take an innate understanding of a complex concept and simplify it so that someone with a rudimentary understanding could grasp the material at hand. Furthermore, they did so in an entertaining and engaging way utilizing clear and concise language that made the material relevant to me. Don’t just tell me that melanocytes are found in the stratum basale of the dermis. Tell me how the melanin of fair-skinned gingers like myself is both produced in smaller quantities and is also degraded more quickly than dark-skinned individuals.

Using relevant examples and clear language in teaching is a simple enough concept but I recall as an undergraduate physics lab TA when it was far from second nature. I remember how unprepared I was. How I fumbled over my words. How difficult it became to describe velocity and sound equations to my peers who didn’t have the same understanding of the material as I did. I wasn’t the best physics TA to say the least but I learned a lot from that experience like the importance of communication in teaching. This brief but captivating 5 minute TED talk illustrates three key points to good communication between scientists and the public. Whether you are a TA or a tutor or just helping a friend with a concept they have trouble with, these three quick and easy communication tips can help anyone improve his or her teaching skills:

First, as Melissa Marshall from the Department of Communication Arts & Sciences at Penn State explains, “When you’re describing your science, beware of jargon. Jargon is a barrier to our understanding of your ideas. Sure, you can say “spatial and temporal”, but why not just say “space and time,” which is so much more accessible to us?” Likewise, the Latin or Greek name for structures often confuse students. Sure, you can use the term ‘profunda brachii’, but you could rather explain how it translates to ‘deep artery of the arm’, thereby making it more relatable [1].

Second, “tell us why your science is relevant to us. Don’t jus tell me that you study trabeculae, but tell me that you study trabeculae, which is the mesh-like structure of our bones because it’s important to understanding and treating osteoporosis. [1]

Lastly, “a slide like this, shown below on the left, is not only boring, but it relies too much on the language area of our brain, and causes us to become overwhelmed. Instead, the slide on the right, an example by Genevieve Brown is much more effective. It’s showing that the special structure of trabeculae are so strong that they actually inspired the unique design of the Eiffel Tower. And the trick here is to use a single, readable sentence that…students…can key into if they get a bit lost, and then provide visuals which appeal to our other senses and create a deeper sense of understanding of what’s being described.[1]

Trabeculae

Ultimately, communication skills are one of the many talents that an individual must master to become an effective teacher. Teaching is an art and quite possibly one of the most difficult arts to master because, as John Steinbeck wrote, “the medium is the human mind and spirit’.

Teaching is similar to other forms of the arts like painting, writing, or playing a musical instrument in that it can be learned. We rely too heavily on ‘the naturals’- people who have innate abilities to teach. Part of the problem is that we rarely teach individuals how to teach. For instance, I have a friend who understands our lecture material far better than anyone I know. He has stellar grades and can easily provide me an answer to almost all the questions I ask him, except he can’t convey his thought process to me. He might understand the material but I can’t understand him. In the end, teachers, tutors, and TAs must work to improve their own teaching skills with assistance from their universities to communicate material more clearly and improve their students’ understanding of lecture material.

1- Melissa Marshall: Talk Nerdy to Me. By Melissa Marshall. Perf. Melissa Marshal. TED: Ideas worth Spreading. N.p., Oct. 2012. Web. 05 May 2013.

 

My Work Ethic

“There may be people that have more talent than you, but there’s no excuse for anyone to work harder than you do” –Derek Jeter

I needed a break after taking my gastrointestinal & renal block exam. A weekend to relax would be amazing. An opportunity to let the thoughts that normally race through my head dissipate. A chance to take a breath after I almost drowned in my studies that left me physically and mentally exhausted. Heck, an afternoon to go grocery shopping, play some soccer, and read a chapter from my Kindle that’s been lying dormant on my desk would be nice. Except for the fact that we start the reproductive block tomorrow. Sucks to suck right? It would if I didn’t enjoy it so much.

Don’t get me wrong, I wish I had more time to just hang out and do nothing, play some Call of Duty, and stay in to watch a movie. But I recognize that I’m putting in my time now so that I can enjoy what I do for a living tomorrow. I didn’t realize how important it was when I was training to play soccer in high school. I thought I just had to show up to practice and play hard during games. I was a talented but lazy soccer player and it eventually caught up to me. I didn’t realize that running sprints today conditions me into a better athlete tomorrow.

It was one of the most important realizations I’ve had during my second semester of medical school. My classmates and I often joke about how hard we work. Compared to undergrads we study every single day as if we have a final exam tomorrow. You can imagine how insane we get when we actually study for our finals. If only I had this same work ethic four years ago I could have gone to ‘one of the Hopkins or Harvards’…or maybe just a stateside medical school. Except that I’m happy here at Ross University.

One of Ross’ principal explicit goals isn’t to push my peers and me into developing a superhuman work ethic per se, but I am yet to meet a peer of mine who has ever worked harder in their life. And I am thankful for it. Ross is the soccer trainer I never listened to.

Studying here is like going to the gym- I don’t personally enjoy working out, but I like how I feel the next day. Likewise, I don’t always love sitting down and studying for hours on end but I love being able to apply medical science after I understand it. And as much as I would like to think I work hard now, I know that the fourth semester students have it twice as bad. They took an exam the same day that I took my GI & renal exam but they have to get right back to the grind to study for their final being held in one week. And then they have to study for their comprehensive exam being held in a month. And then they have to study for their Step exam. It never ends.

It’s not like when I graduate from medical school I’ll just stop studying or working as hard as I do now. If anything, that’s when the hard work that goes into the core sciences at Ross will finally pay off. It will be that much more gratifying when I get to actually treat patients and will motivate me to push myself even harder. That’s why the relaxing afternoons after my exams are one of the most important days of the semester.

I got to see a glimpse into my life as a fourth semester. I’ll have to study just as hard as I did for my last exam but will have to continue studying just as hard the following day for a final. And keep on going until I graduate. And then keep on going until I finish my residency. And then keep on going until I finish my fellowship. As I continue to progress through my medical education, I will rarely be able to mentally checkout for a weekend while I recuperate from the caffeine and cortisol driven weeks of study and work. My daily grind involved in sustaining my life as a med student will eventually evolve into a nonstop grind involved in being a practicing physician. This is why Ross has not only improved my work ethic, but has even forced me to consolidate how long it takes me to relax and then get back into the swing of things. I simply can’t afford anything less than being maximally efficient with my time. My mental health and academic performance depend upon it.

Pre-meds: Do what it takes to get into medical school

I sit at my home in New Jersey as I anxiously await my 6am flight two days from now that will take me to the Caribbean island of Dominica where I will begin to take my first steps in the journey of becoming a doctor at Ross University School of Medicine.

 

Many people attempted to discourage me from continuing on the path I started on. Doctors I shadowed would warn me of the daunting hours, how much medicine has changed over the years, and how you can make more money in other fields for the amount of time you put in. Even my undergraduate pre-med guidance counselor at Binghamton University told me, on several separate occasions, that I simply did not have the grades to get into medical school. And these people were right…sort of.

 

It is true that medicine is changing. And you can more than likely make more money in business or in banking. And at the time, I did not in fact have the grades to be accepted into medical school. I am here to tell you that can get into medical school, even a stateside school, if you want it badly enough. This isn’t to say that your past mistakes will vanish into thin air- that ‘C’ in organic chemistry isn’t going anywhere. What you can do is affect your future. Show that you remember your mistakes and learn from them.

 

Likewise, I try to forget the people who attempted to dissuade me from medicine, but remember the people who accepted my decisions and encouraged me along my path. The one doctor I spoke with at a high school graduation party of a mutual family friend who highlighted that, “It doesn’t matter how many rejections you get, because in the end you only need one acceptance”. Or my parents who pushed me to apply to that reach school after explaining, “I’m not doing myself any favors by rejecting myself before even applying”.

 

I am here to give you a pat on the back and a kick in the ass. I had to take the MCAT twice and had to apply to twenty-eight medical schools, but all it took was one acceptance to make it all worthwhile. If you have explored medicine and have decided that it is the path for you, don’t let anyone discourage you from it. Own it and do whatever it takes to succeed. It is what I intend to do starting September 3rd on my first day of class down in Dominica.

As seen on @KevinMD