MedEx Day 12 - July 14, 2021

To begin the middle of the third week of MedEx Tier III, we had a Kaplan class in the morning on Chemistry and Physics. I enjoyed getting to review my skills and study for the MCAT. Afterwards, Caroline Loftus and some of the other program advisors led Tier III in a discussion about interviews, specifically the first question, "Tell me about yourself." The advisors once again enlightened us about the usefulness of AIDET- an acronym standing for acknowledge, introduce, duration, explanation, and thank you- for introduction, including this question. The program advisors also recommended that as an interviewee we use this opportunity to share about what really matters to us/ what interests us enough to participate in during our free time, in order to drive some of the interviewer's questions. I greatly appreciated this advice/ plan to practice my interview skills soon.

After this, Tier III had a lecture about achieving optimal health in older adults/ geriatrics care in general. To begin this lecture, we went through 10 common myths about elderly adults including that they are generally the most depressed generation, that they need less sleep, and that everyone will get some form of dementia (only about 11% will). Throughout this presentation the major theme was about the importance of considering the cultural background/ values of the patient that we were treating. With respect to older individuals, by 2030, people over 60 will make up over 30% of the population in SC. I also found it extremely interesting that the best predictor of longevity in someone's lifetime is the degree of social integration that a person has/ how many close relationships someone forms and keeps over time.

To close the day, Tier III watched and discussed a movie called Code Black. This movie was about the ED at the county hospital in LA. At the beginning the film focused on the cooperativity between the departments/ people in the ED at this particular hospital. The film portrayed this through an area called "C-Booth". This was a small area where three surgical beds were squeezed close together, allowing for greater collaboration between physicians and healthcare workers in this OR. This area was also where the most critical patients were taken. According to the film in this small area, the most lives per year were saved and died, if calculated lives per square feet. As the film went on the focus shifted as the hospital moved locations/ C-Booth disappeared. This also occurred simultaneously with the development/ greater enforcement of HIPAA and other regulations on healthcare providers. The residents in the film discussed how their job became more about paperwork than seeing patients. The film also began to highlight the healthcare disparities between hospitals, since only some hospitals accept patients without insurance/ others turn patients away (thankfully this is no longer the case). To close, the residents began to try to implement changes to bring back the community aspect of "C-Booth" from the old location/ they saw wait times decrease for patients.

The most interesting parts of the film were the discussions of inequality in healthcare and the role physicians play in caring for patients and their families. One of the residents talked about how doctors have to care for patients and their families pretty similarly, since a patient may be physically sick; however, the patient's family could be "sicker" with regards to mental state and mental illness. This reminded me of a provider at MUSC who told me that as a physician, "Your worst day is someone else's best day/ be the sunshine in everyone's day." As an aspiring doctor, I am committing to caring for everyone/ making sacrifices so that a patient and their family can get the care that they need. The fact that some patients used to be turned away from a hospital for lack of insurance is very disturbing, considering that for some patients this could be the difference between life and death. The film certainly highlighted things that could be improved within healthcare to make it more accessible to all. It also demonstrated how as a physician I will need to have resiliency/ adaptability when situations change and a service orientation to all who I encounter.