Practice-Based and Life Long Learning CEO 3.4. Identify one’s own strengths, weakness, and limits;
- a) seek and respond appropriately to performance feedback
- b) maintain an appropriate balance of personal and professional commitments
- c) seek help and advice when needed
Throughout medical school, I have sought performance feedback and incorporated it into my growth going forward. This for me is a natural process that in my estimation leads to better performance. I have visited the academic counselor for advice many times. For example, together, we developed a plan to study for Step 1. Based on my previous NBMEs and my target score, we determined just how many questions to answer and pages to read. Ms. Kelly-Ann Perry also connected me with the irreplaceable Dr. Grieco, who helped me organize and focus my studying. Thanks to their help, I was able to achieve a decent Step 1 score, well above the value predicted by my first NBME.
Another example of where feedback helped performance was with objective structured clinical examinations (OSCEs). I began by reading my feedback and rewatching my videos. I also reached out to Dr. Curren, who rehearsed strategies with me to improve my OSCE skills. When it came time to study for the ultimate OSCE, Step 2 CS, I made use of the fine resources offered by the College of Medicine. I took a practice Step 2 CS-style OSCE, reviewed my results, studied with several faculty members to learn strategies, and took a second practice Step 2 CS-style OSCE. As a result, I passed the Step 2 CS examination.
In trying to decide what path to take with my fourth year, I sought feedback from my otolaryngology mentor, Dr. Lind. I was really excited about otolaryngology, which was the most energizing of any of my rotations, but I felt insecure about how my progress in medical school would be evaluated. I wondered to her if my scores were good enough, if I genuinely needed to have honors in everything, if I had enough research, and if I needed to do two away rotations. She went out of her way to sit down and talk with me, and she said that she thought there would be otolaryngology programs where I would be a good fit, but that I should definitely do more research and one away rotation. I then talked to Dr. deSilva, the otolaryngology residency program director. He told me seriously that I needed to do two research projects, and I took his feedback to heart. Through the educational coordinator for otolaryngology, I found two projects that unfortunately didn’t work out. So I went back to Dr. Lind for more feedback on how to find a project. She networked me with two of her co-workers at Nationwide Children’s, and happily, I had found my two much-needed projects. Over my research month, I performed a chart review and bench research. I also applied for an away rotation through VSAS. I listened to their feedback and put it into action.
Throughout medical school, I have worked to maintain an appropriate balance of personal and professional commitments. It has been observed that physicians who give up all of their pre-medical school hobbies are poorer for it. Without those varied life experiences, they have less depth to draw upon as physicians. I have enjoyed art since I was a small child. The spatial understanding nurtured by art will assist me in surgery, and the human aspect of art connects me to the deeper humanity within us all.
Since high school, I have enjoyed making costumes from scratch. The hobby connects me with my friends around the globe who also enjoy costuming. I made Pharma, in Figure 2, during my second year of medical school. Pharma is a Transformer who serves as a transplant surgeon. I enjoyed the challenge of the details of his design. He was mostly made of Spandex and stretch pleather stretched over foam. Pharma won 2nd prize in the TFcon 2014 cosplay competition in Mississauga, Ontario, Canada, an internal Transformers convention where I treasure the chance to meet up with friends I do not see often. I put Pharma to good use, playing a role in the skit “Grade Expectations 2: Kevin’s Revenge” for Nite Out, the medical school talent show to raise money for the Columbus Free Clinic.
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Figure 1: Pharma, comparison with comic reference.
In my second year of medical school, I made the Transformer Springer, who triple-changes into a futuristic helicopter and rocket car. In Figure 2, I show how the comic design inspired me in crafting my Springer costume. The Springer costume is constructed mostly of Wonderflex, a heat-shapeable thermoplastic similar to the Aquaplast sometimes used in the operating room or the thermoplastic splints made by physical therapy. Springer won the “Best Transforming” Prize in the TFcon 2015 cosplay competition.
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Figure 2: Springer costume, comparison with comic book references.
My next costume was Override Prime in Figure 3, one of the first female Transformers characters to be shown in a leadership role as a starship captain. She was mostly made of Wonderflex, like Springer. I sculpted and hand-cast her wheels from resin, and I included multiple light-up elements in the costume.
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Figure 3: Override Prime, comparison with concept design.
In addition to costuming, I enjoy many forms of art. With Dr. Hitchcock and Courtney Tipton, we put together a skit on “Comple(i)ment” (2014). I also organized the first ever OSUMC Pathology Cooking Show with Dr. Hitchcock, bringing to life the concept he had talked about for years: non-stop pathology food puns, along with student teamwork and culinary excellence. I love carving foam pumpkins, as shown by a pumpkin I carved for Halloween 2016 in Figure 4. As a part of Humanism in Medicine, I learned to etch glass from one of the fine workshops put on by Dr. Stone in conjunction with the Glass Axis. I retained those skills and put them to use hand craft floral glassware for my mother as shown in Figure 5. Another hobby is 3D printing, which combines my engineering undergraduate degree with art. Figure 6 shows a symbol bracelet where I made the 3D models, had them printed, and then assembled the bracelet myself.
Figure 4: Halloween 2016 pumpkin.
Figure 5: Christmas 2016 glassware etched as a gift for my mother.
Figure 6: 3D printed steel bracelet with sterling silver findings.
Through my medical school career, I have sought help and advice when I needed it. Endo/Repro was a struggle for me. So in studying anatomy, I reached out to Antoinette, who obviously knew what she was doing. She, Alex, and I would get together at 7 AM every morning to go study anatomy. By the end, we had memorized every structure on every cadaver. We studied so hard, our skin started to flake and peel from the formalin in the air. Other students started reaching out to me for help with anatomy, So, I jumped in to help, which incidentally reinforced my own understanding. My peers recognized these efforts with the Candy Apple Award, which I proudly display on my white coat. The best thing about help and support is being able to pass it on to others.
I have come to realize that it was not just luck that exceptional and accomplished people are seeming “there” just when I needed them. Dr. Grieco assisted me in structuring and organizing my studying, which helped me achieve a respectable score on Step 1. Dr. Lind, my otolaryngology mentor, was there with timely suggestions for research that fitted well with my skill-sets. I worked on both projects over my research month. I put one study together as a poster for SENTAC (put in the poster as a figure) and am working on a methods paper based on the other project. Every organization has these kinds of unique and caring individuals, willing to go above and beyond. When it is my turn, I aim to be one of these.
Knowing when support and guidance are needed will be critical as a resident and even as an attending. On my Infectious Disease and then Surgical Intensive Care Unit (SICU) rotations, I enjoyed rounding with PharmDs and observed how their help and advice improved the team and patient outcomes. PharmD knowledge can span beyond pharmacology and the intricacies of dosing. Once, we had a patient who was recovering from a re-do Nissen fundoplication and developed unexplained fevers, high white blood cells counts, and atrial fibrillation. Our PharmD had seen this scenario before, often enough that he had actually published on it. This sort of post-operative atrial fibrillation correlated with an esophageal leak, which we soon determined the patient to have. The patient’s leak was treated, and he did well. When I needed advice about Burkholderia cepacia and couldn’t find recommendations on the antibiogram on the Antibiotic Stewardship website, one of the PharmDs I had worked with on Infectious Disease quickly answered my e-mail with up-to-date information about susceptibility trends. She had previously helped me with a music video for Nite Out, the medical school talent show to raise money for the Columbus Free Clinic, in Figure 7.
https://drive.google.com/file/d/0B0VTELlnPMzJMTJZN0dpNWVLQmM/view?usp=sharing
Figure 7: Bad Bugs video.
On surgical oncology, when one of the younger attendings felt unsure of her flap, she asked another attending for advice, who easily explained the surgical anatomy, speeding up the surgery and saving time for the patient. In the SICU, one intern showed another how to pull chest tubes. Information transfer is both vertical and horizontal, all for the betterment of patients. Passing information is like passing a torch, all to keep the light burning strong. Learning is a marathon, and I’m in it for the long run.