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Get Involved in Medical Education: Part I
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Get Involved in Medical Education: Part I
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[Dr. Smith] Welcome back to Run the List, a medical education podcast in partnership with McGraw Hill Medical. Our hosts are Dr. Navin Kumar, Dr. Walker Redd, Dr. Emily Gutowski, Dr. Joyce Zhou, and myself, Blake Smith. As a quick disclaimer, this podcast is meant for informational and educational purposes only, and should not be understood as medical advice under any circumstances.
[intro music] [intro music] [intro music] [Dr. Smith] Welcome back to Run the List, today we're very lucky to be chatting with one of our very own, Navin Kumar. If it's your first time listening to Run the List, he is one of the core team members of the pod and one of the founders of the podcast back in 2019.
As some of you may remember, last summer, July 1st, we started a partnership with McGraw Hill Medical, which at the time we had hoped would elevate both the quality and almost the quantity of our episodes, and I think in the past season we've achieved that. And so we're going to continue this partnership, keep the momentum going with what we've achieved this past season. Be on the lookout for July 1st, this coming summer for season two, where we will cover some of our early episodes again with new content and hopefully improved quality as well.
In the meantime, we're going to be chatting with Navin about medical education, a topic very near and dear to our hearts and also to many of our listeners', and hopefully get some anecdotes from him and some pearls about being involved in medical education or even just bearing witness to the medical education wave that's currently happening both in the classrooms and digitally.
So with that, we'll Run the List. Navin, now that we have you here on the pod, when did you first become interested in medical education? [Dr. Kumar] Yeah, Blake, thanks so much for having me, really fun to be on the other side of the microphone for this topic. You know, for me, the interest into medical education honestly started in college when I was a pre-medical student and I was just so amazed by some of the professors who would teach us in these really large lecture halls and somehow have an ability to engage with us in a way that almost felt like they were just teaching us individually.
I'm sure you've had that experience too, Blake, when you were in college and just like- [Dr. Smith] Oh, absolutely. [Dr. Kumar] Right? There's like a few teachers who just knew how to do this so well and you would walk in knowing that for that hour, you were going to learn really effectively and in a way that was very engaging. So I loved just being a part of that and seeing these professors teach in that way and it was inspiring.
I looked at it and thought, you know what? It'd be really cool if I could get to some degree of that level when I was actually a physician myself. of that level when I was actually a physician myself. So that was college and you know, that appreciation for really great teachers just continued while I was in medical school and obviously like, you know, the content changes once you're in medical school, it becomes a little bit more specific and the lecture halls get a little smaller, the class sizes are a little smaller, but just like in college, I saw those same really great teachers from time to time and I was constantly amazed by how they were teaching content that was really complex but they could deliver it in a way that seemed more simple and easy to understand in the larger groups.
But then also, you know, in medical school you do, as you know, Blake, a lot of small group work, and I loved how some of my best small group leaders were really flexible in the way they taught, and they were able to, you know, kind of pivot the session based on what us as the students were bringing up, but still at the end, they were able to bring us back. I'm thinking mainly of the case-based tutorial sessions I would do as a first or second year student, and just see how at the end, even though we had like a very winding path where like, we were getting up and writing things on the chalkboard, looking things up on the internet, during the session we arrived at a place where we covered all the objectives that that small group leader had for us when we started out the case.
So it was just kind of this continued exposure to really great teachers, and of course, it's not everyone, right? [both doctors chuckle] [Dr. Kumar] So I definitely saw my fair share of teaching that was not effective, but it was the really effective teachers that helped me get interested in pursuing a career in medical education.
And then it really came together during my clerkship year when I was on the wards at the Brigham as a third year medical student back then, and I was just so impressed by watching my senior resident teach not only the interns my senior resident teach not only the interns but also the medical students on her team. It was just so impressive to see how she could run a team really effectively, provide really high level patient care, but also find time to teach during, before, after rounds in small tidbits, and this is like something I've taken for myself, the way I teach now is like trying to be very high yield.
I think it's something we've discovered with our Run the List podcast, is that you can teach very effectively in not a large amount of time if you're prepared and you have clear objectives. So by the time I got to clerkship and I saw this one senior resident I'm thinking about, I saw her as both a team leader but also an educator. It was pretty clear that that was a pathway I wanted to go down and I wanted to be just like that resident, but also those really impressive professors I had from before.
[Dr. Smith] Yeah, definitely. I like that you kind of all along from college, in your narrative of your experiences now, you were very perceptive to the educators around you and I think something that's interesting about medicine is that in high school or in college, we have these teachers in front of us at the blackboard or at the chalkboard, what have you, but in medicine you could have people teaching you at kind of every level of the game, if you will.
So you could have residents that are teaching you as effectively or even more effectively at the bedside as a professor that you had during M1 or M2 at the whiteboard. So I really appreciate that and that's something we're going to focus on in this episode and the next one, in our second part, is just kind of the different forms of education. But why don't we kind of start at the beginning?
You know, I think of you as one of the core members of our team and someone who always knew that they wanted to be a doctor but also as a medical educator, it seems like you've kind of had this throughout, but maybe that's not the case. So what advice do you have for students who are interested in MedEd, whether they were thinking of that from the beginning or kind of came at it, you know, during M4 or even intern year?
[Dr. Kumar] Yeah, Blake, so what I'll try to do during this first part of the medical education podcast series is I'm going to try to give some tips. So the first tip I want to give to those early listeners who are either students or maybe interns interested in getting into medical education, is to start early and often. And so what I mean by that and I'll try to connect it to what I did as a third year student, is that I really pushed myself to teach whenever there was an opportunity.
And so as a third year clerkship student, I found that generally towards the end of the week, usually on Fridays, the team would reserve some time for protected education led by someone on the team. for protected education led by someone on the team. And oftentimes that took the form of either the attending or the senior resident doing like, you know, a 15-minute talk on a certain topic that came up during the week.
And I found that as an opportunity where I could put myself in that situation and try to educate my team members, even though I knew I was a third year medical student, and you know how it is as a student, it's hard to teach above you, it's much easier to teach at your level or to those who are earlier in their career, but I found that putting myself in that position really helped me learn from an early stage, how to become a more effective teacher.
And so I think the take home point here is that, especially when you're earlier on in your career, all of these opportunities to teach are going to be very stressful and it'll be easy to shy away from these opportunities or not seek them out to teach in front of your peers, or again, like individuals who are more advanced in their training, very easy to shy away from. But if you put yourself in that situation and you get up there and you get up to the chalkboard and you come prepared and you do your talk, you will learn so much about techniques on effective teaching but also get really great feedback.
Blake, you can probably attest to this, it's really easy to get good feedback when you're earlier in your career- [Dr. Smith] Definitely. [Dr. Kumar] It gets harder as you move along, very hard for me now as an attending to get feedback on my teaching from someone on my level, but very easy for me to give feedback to my student who just gave a 15-minute talk.
So I think the idea of pushing yourself to teach whenever the situation, the opportunity arises, is really, really important. So that's third year and then I want to think more about when I was a fourth year student. This is when you start having the opportunity to actually take on more formal roles as a teacher. And so for me that presented itself as a student tutor for our clinical skills course.
I imagine this is applicable at a lot of different medical schools where more senior medical students can actually fulfill a formal role in a course as a student tutor. And so what this looked like for me was I would teach in a small group setting where I definitely felt less pressure. And again, I was teaching a level below me to some degree and so that gave me confidence that I could teach well and effectively, also knowing that I was just in their shoes a few years ago, I think, right?
That makes you a more effective teacher. And it was topics that I knew well, I knew the physical exam really well, coming out of that clerkship year, how to take a history with a patient. These are all core skills that I had been practicing the whole year and so I felt that I could teach it effectively. So that was a great way for me to become more involved formally in a course.
Third year was more informal, pushing myself to teach my teams whenever I had the chance. And then fourth year was about starting to take on some more formal roles within the medical school curriculum. [Dr. Smith] Yeah, I think that highlights kind of the, what I was getting at earlier with medical education is that it could take many forms by many teachers, many kind of leaders on teams in the hierarchy of medicine.
many kind of leaders on teams in the hierarchy of medicine. And so could you touch on, I guess, formal versus informal teaching in medical education? You know, we all, I guess, know of the formal teaching in the first year, year and a half, even two years, depending on the medical school and then maybe clerkship on the wards, but what about informal teaching and how that played a role in your experience?
[Dr. Kumar] Yeah, absolutely. I think, as a student, I was the recipient of a lot of informal teaching during any clerkship or clinical elective, and that gave me insight and we'll dive into this a little later about what I could do once I became an intern. So a lot of this happened just kind of off the cuff. We came out of a patient's room where there was a physical or within the patient room there's a physical exam finding that the intern or the senior resident was demonstrating.
You know, I remember being a clerkship student and being asked to listen to the heart on rounds, right? I feel like a lot of med students have had this experience where you're told there's something, and then you're on the spot to go and listen, and you are, it's funny, right? Because one option is to pretend - you heard something, right? - [Dr. Smith chuckles] [Dr. Kumar] Like no one actually knows if you actually heard it, but then if there are follow-up questions, you will not be ready to answer those if you didn't actually hear it.
So I remember being put on the stage, listened, sure enough, I heard a murmur, and then the next move was I couldn't tell if it was systolic or diastolic. And so it was so funny, I remember actually feeling the pulse and then out of the corner of my eye, I could see my attending like nodding his head, knowing that okay, Navin is now trying to distinguish this from a systolic and diastolic murmur.
So I knew I was on the right path and sure enough, it was a diastolic murmur, and then based on the location, it seemed like it was an aortic insufficiency murmur. I said that at rounds and I got it right and it felt so good. - [chuckles] - [Dr. Smith] That's awesome. [Dr. Kumar] So right? Like a lot of this teaching happens informally, but then there are obviously opportunities for formal teaching that we can, again, dive into once we talk about what you should start doing as a resident, but I think it's a really good point you bring up is that so much of this medical education happens spontaneously just from patients or clinical situations that arise while you're in the hospital.
And as a student, you should be ready to receive that learning and see how your teachers are presenting that material so that when you are in that position, you can do the same for, you know, the next generation of learners. [Dr. Smith] Yeah, absolutely. Would you say in your experience you had these kinds of opportunities come to you or kind of happen on the spot?
I mean, I think you touched on both of them in your clinical skills course teaching, but then, you know, having to diagnose aortic insufficiency on the spot, you know, so, because medical education is so almost shape-shifting or hard to pin down because it happens in many forms in many, you know, arenas. Do you think that for your involvement in medical education in the past and currently, a lot of it has kind of been presented to you and you're like, yeah, sure, I'll do this.
Or you've had to seek it out or both? [Dr. Kumar] Yeah, this is exactly where I want to go. One of my tips is to say yes and I think it's so important early on in your career, and this starts when you're a student, that when opportunities arise and you know, leaders in medical education within your own institution, your own medical school, come to you with opportunities to teach, you go for it.
And it's always a lot of work to put together, let's say, a new talk on a certain topic. I find that, you know, to teach like half an hour for me, honestly, it takes like, it takes several hours to put together that half an hour, 45 minute talk, but I've learned that once you've made that talk, you now have it and you have it for the rest of your life and you can teach it with edits, you know, as new information comes along, but that's your content and you can teach it so well because you made it yourself.
So I think it's really important to say yes when you do have these formal opportunities to become involved in medical education. The other important piece of saying yes is that it helps you build a reputation. And so I tried to start doing this as, like I said, a senior medical student by taking on more formal roles, I was starting to try to build my own reputation as a future educator and it's so funny because you know, I now work alongside folks in medical education who taught me and now we're peers, right?
And it's been really hard for me to start calling them by their first name, but I've learned to be able to do that over time. When it comes time for you, once you finish training and you're about to seek your first job, you now have individuals who have power in a position in medical education who know you as an educator so that when there's more formal leadership roles that come up, you're right there at the head of the potential applicants and they will actually come and seek you out.
So I think when you were talking about looking for these opportunities, it hits home with me that yes, some of these things you're going to seek out for yourself, but if ever presented with opportunity to become involved, go for it, say yes. It's going to take time but especially early in your career, it's very, very important to get involved. [Dr. Smith] That is such a great tip and I like how it kind of becomes circular where we're saying yes to something informally that maybe is presented to you can ultimately lead to something where people then seek you out because they know you as an educator.
You know, because this first part is focused more on early trainees, you know, maybe upper year med students, it's interesting to me, especially doing this podcast with you all still as a medical student myself, it's like, it's almost like chicken and the egg where getting involved in medical education while you're still in the student phase feels kind of strange, you know?
So it's like, how do you find that as a student and on top of that, because medical education is changing in this digital era, because medical education is changing in this digital era, can students innovate while they're still in the student phase of training? [Dr. Kumar] Yeah, Blake, so I think that's a really nice point you bring up and, you know, there's always this - and I see this in my own students that I teach -, this sense that because I'm a student, I can't be an effective educator just because I'm so early in my training- - [Dr. Smith] Right. - [Dr. Kumar] -but I feel that I want my students to look at it differently, which is that being a student, you're one of the best candidates to think about medical education because you know what you have been receiving and you can identify ways to do it better.
So this idea of innovating is really important and it's a great way to become involved as a medical student, and I think that starts with looking at your own curriculum and seeing if there's a gap there that needs to be filled and then either formally or informally getting a sense of, is there a need? You see the gap but if you talk to your friends and peers, is there a true need for a change?
I had a student who I worked with who did a wonderful job of going through this process of innovating by first doing a needs assessment amongst her entire class, identifying that there's a gap in the curriculum, namely global health during the clerkship years, and she wanted to tie that in longitudinally between all the different clerkships that occurred during the principal clerkship year.
And so her process that I'll share, because I think there's some good takeaways here, is that first she identified the gap and she found a mentor, myself, to help guide her through this process. So I think that was key, find a gap, find a mentor. Then after confirming that this was a true need by surveying her own student body, she then met with all the educational leadership of the clerkship year and she presented her idea formally.
of the clerkship year and she presented her idea formally. So she put together a really nice presentation and had it backed by data from her survey that this was a true gap in the curriculum. She then did her innovation, which was creating a global health didactic series that ran through the clerkship year between surgery, pediatrics, OB/GYN, internal medicine, and what I love and that she did, and again, this is, I don't want to toot my own horn, but this is what happens when you have a mentor, is that you have a mentor who can push you a little further.
And so we were able to- I was able to push the student to study the innovation and not just develop it. So she did a really nice job of creating surveys, both before and after the curriculum, and she collected really, really good data that showed that it was a very effective curriculum that she innovated and introduced into the clerkship year. And then the final piece was that she wrote up her work, both as her main research project of her medical school career, but then she was successful in publishing this innovative curriculum in MedEd portal, which is a great resource, great place to publish this type of work.
So there's a lot of great learning points from what this student did, but it all starts with finding a gap, seeking a way to fill that gap, and doing it with the help of a mentor who can also help guide you through the scholarly process of hopefully publishing the hard work you've done. [Dr. Smith] Wow, that's an amazing story and something that, you know, directly answers kind of what I was asking about.
Innovating as a student for, I guess, your own class, but even future classes for medical education. So that kind of perfectly fits that question. I guess you gave so many tips, maybe it would be helpful to wrap up this first part of the two-part series and give us some pearls for early trainees. Ways to get involved in medical education and things to be mindful of because you are obviously advancing up the medical hierarchy and that transition to residency.
[Dr. Kumar] Excellent, yeah. So let's review my tips again. So number one, to start early and often, and remember this can start absolutely as a medical student and it should start then. If you're interested in medical education, seek out those opportunities, informally teaching on the wards versus formally becoming a student tutor in some of the clinical skills courses while you're still a medical student.
So again, start early and often. Second tip is, as we mentioned, say yes. So when opportunities arise, say yes, and build your reputation as an educator, even as a student, but certainly once you enter residency. And number three is to practice your skills. And so what I meant by this, and we didn't get a chance to talk about this earlier, but I'll reflect on it now, is that it's really important to commit to teaching.
I always found that sometimes, especially when I began as an educator, I would prepare teaching and then when it was time for me to teach, I would get shy and I would get nervous, and you can easily let that opportunity just slip. There's always reasons, especially in the hospital, right? Where you push teaching to the next day because it's too busy, but what I did as an intern is I would informally teach my students, right?
This was the kind of stuff we talked about earlier, where you teach about the exam, or when you come out of a room, you teach about, you know, a medication dose that you titrated, but then as a resident, it's time to start actually preparing for teaching and what I found was helpful is that I would always start rounds with five minutes of teaching because I felt like if you didn't do it up front, before you know it, the day has gone away from you and it's really hard to stop the momentum of all the work that's building up to teach later in the day.
So I always taught in the beginning and I would do five minutes, I'd come prepared, I knew what I wanted to teach, and then I felt like I could check that box, that I taught my interns and I taught my students, and now let's move on to the patient care while still doing some more informal teaching throughout the day. So just to summarize again, this final tip is really to practice your skills, both informally and formally within your role as a student intern or resident.
[Dr. Smith] Thank you so much for those pearls, Navin, and we'll see you in the next episode. [Dr. Kumar] Awesome. Thanks, Blake. [outro music] [outro music]